The Damage Of Spinal Cord Effects On Timing Of Surgery In Traumatic Central Cord Syndrome

Object The purpose of this study was to find out the timing of surgery by the regression and assess admission ASIA motor score effecting on timing of surgery in TCCS. Methods From April 2006 to August 2014, date of patient in TCCS who had undergone the anterior decompression and fusion was reviewed. managed for TCCS at our department was performed. Fifty-four patients(46 male, 8 female) with a mean age of 47.9(range, 25-71) years were treated for TCCS. The admission ASIA motor score was an average of 70.6 with a SD 20.4 The midsagittal diameter of spinal canal, MCC%, and MSCC% were 6.1±1.6mm,40.8±17.9% and 8.4±22.1%, respectively. The length of parenchymal damage(signal change on MRI) was 27.8 ± 21.5mm. Mean time for follow-up was 49.4(16-114) months and the mean follow-up ASIA motor was 96.1 with a SD 6.1. The hypothesis that the timing of surgery was a categorical variable was given. Stepwise regression was performed to find a regression equation that related the predictors to the outcome of TCCS. And the patients were graded into 80-100?60-80?40-80?20-80 and 0-80 groups by admission ASIA motor score. Each group was stratified into the early group and the delayed group by the timing of surgery. The analysis of variance was used to compare the outcome of the early group and the delayed group.Results Patients with higher admission ASIA motor score had higher follow-up ASIA motor score(p< 0.001). patients performed surgical management within 6 days after injure had high follow-up ASIA motor score(p= 0.014). The patient with higher MSCC percent had a lower follow-up ASIA motor score, but not significantly(p = 0.064). There was no difference in the follow-up ASIA motor score between early(98.8 ± 2.8 points) and delayed(98.4 ± 4.2 points) groups(P = 0.703) in TCCS with amission ASIA motor score ranging 80-100. For patients with amission ASIA motor score ranging 60-80, the follow-up ASIA motor score of the early group was 98.1( ± 2.0) points versus 94.3( ± 4.3) points of the delayed group, respectively(p = 0.008).For patients with amission ASIA motor score ranging 40-80, the follow-up ASIA motor score of the early group was 97.5( ± 3.4) points versus 94.3( ± 4.3) points of the delayed group, respectively(p= 0.043). For patients with amission ASIA motor score ranging 20-80, the follow-up ASIA motor score of early group was 97.0(±3.7) points versus 91.8(±9.1) points of late group, respectively(p = 0.030). For patients with amission ASIA motor score ranging 0-80, the follow-up ASIA motor score of the early group was 95.7( ± 6.0) points versus 91.8( ± 9.2) points of the late group, respectively(p= 0.151).Conclusion Not having surgery within 48 hours, patients in TCCS, having surgery within 6 days after injuries, had better outcome.,Patients with the admission ASIA motor within 80, having surgical decompression within 6 days, had better outcome.