Early Decompressive Surgery in Traumatic Thoraco-Lumbar Spine: When and Why?
|Alessandro Landi*, Angela Ambrosone and Roberto Delfini|
|Department of Neurology and Psychiatry, Division of Neurosurgery, Sapienza University of Rome, Rome, Italy|
|*Corresponding Author :||Alessandro Landi MD
PhD, Department of Neurology and Psychiatry
Division of Neurosurgery, Sapienza University of Rome
Italy, Viale del Policlinico 155, Rome 00181
Tel: +39 06 49979105
E-mail: [email protected]
|Received: April 05, 2016; Accepted: April 26, 2016; Published: April 28, 2016|
|Citation: Landi A, Ambrosone A, Delfini R (2016) Early Decompressive Surgery in Traumatic Thoraco-Lumbar Spine: When and Why? J Spine 5:301. doi:10.4172/2165-7939.1000301|
|Copyright: © 2016 Landi A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Spinal trauma is a very common disease, associated with spinal cord injury in 15-30% of cases. The treatment is affected both from non-modifiable variables (fracture’s morphology and biomechanics of the trauma, fracture site, neurological status, primary or secondary comorbidities) both from modifiable variables (first aid and hospital transportation, supportive therapy, surgical timing etc.). The role of the surgical timing after acute thoraco-lumbar spinal cord injury is still one of the most controversial points actually debated in literature. Surgical treatment is conditioned both by the general conditions of the patient both by the extent of the neurological deficit. In literature are described three possible windows for surgical timing: early surgery , performed in the first 48 hours; intermediate surgery, performed between 48 hours - 7 days; late surgery, performed after 7 days from the injury. In the light of the debatment actually under discussion in literature, the real question is: The implementations of the early surgery have effectively a role in the management of thoraco-lumbar spine injury and, if so, when is mandatory? Actually, based on the literature evidence, is extremely difficult to find a clear indication.