Natural history and surgical outcomes of idiopathic spinal cord herniation.
Spinal Cord
; 61(8): 441-446, 2023 08.
Article
in En
| MEDLINE
| ID: mdl-37380759
ABSTRACT
STUDY DESIGN:
Retrospective multicenter study.OBJECTIVES:
Although surgery is frequently selected for the treatment of idiopathic spinal cord herniation (ISCH), its impact on functional outcomes has yet to be fully understood given the limited number of patients in previous studies. This study aims to evaluate the symptomatic history and surgical outcomes of ISCH.SETTING:
Three institutions in Japan.METHODS:
A total of 34 subjects with ISCH were retrospectively enrolled and followed up for at least 2 years. Demographic information, imaging findings, and clinical outcomes were collected. Functional status was assessed using the JOA score.RESULTS:
The types of neurologic deficit were monoparesis, Brown-Sequard, and paraparesis in 5, 17, and 12 cases, with their mean disease duration being 1.2, 4.2, and 5.8 years, respectively. Significant differences in disease duration were observed between the monoparesis and Brown-Sequard groups (p < 0.01) and between the monoparesis and paraparesis groups (p = 0.04). Surgery promoted significantly better recovery rates from baseline. Correlations were observed between age at surgery and recovery rate (p < 0.01) and between disease duration and recovery rate (p = 0.04). The mean recovery rates were 82.6%, 51.6%, and 29.1% in the monoparesis, Brown-Sequard, and paraparesis groups, respectively. The monoparesis group had a significantly higher recovery rate than did the Brown-Sequard (p = 0.045) and paraparesis groups (p < 0.01).CONCLUSIONS:
Longer disease duration was correlated with the progression of neurologic deficit. Older age, and worse preoperative neurologic status hindered postoperative functional recovery. These results highlight the need to consider surgical timing before neurologic symptoms deteriorate.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Diseases
/
Spinal Cord Injuries
/
Brown-Sequard Syndrome
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Spinal Cord
Journal subject:
NEUROLOGIA
Year:
2023
Document type:
Article
Affiliation country: