Management and prognosis of acute traumatic cervical central cord syndrome: systematic review and Spinal Cord Society—Spine Trauma Study Group position statement

European spine journal

article

P. K. Karthik Yelamarthy¹  H. S. Chhabra¹  Alex Vaccaro²  Gayatri Vishwakarma¹  Patrick Kluger¹  Ankur Nanda¹  Rainer Abel²  Wee Fu Tan³  Brian Gardner¹  P. Sarat Chandra⁴  Sandip Chatterjee⁵  Serdar Kahraman⁶  Sait Naderi⁷  Saumyajit Basu⁸  Francois Theron⁹ 

[1] Spine Unit, Indian Spinal Injuries Centre;Department of Orthopaedic Surgery, Richard H. Rothman Hospital, Thomas Jefferson University Hospital;Department of Neurology, VU University Medical Center;Department of Neurosurgery, All India Institute of Medical Sciences;West Bengal Health University;Anadolu Medical Centre;Department of Neurosurgery, Umraniye Teaching and Research Hospital, Health Sciences University;Park Clinic;Department of Orthopedics, University of Pretoria

关键词: Traumatic;    Cervical;    Central cord syndrome;    Management;    Timing;    Complications;    Prognosis;   

DOI  :  10.1007/s00586-019-06085-z

来源: Springer

【 摘 要 】

Spinal Cord Society (SCS) and Spine Trauma Study Group (STSG) established a panel tasked with reviewing management and prognosis of acute traumatic cervical central cord syndrome (ATCCS) and recommend a consensus statement for its management. A systematic review was performed according to the PRISMA 2009 guidelines. Delphi method was used to identify key research questions and achieve consensus. PubMed, Scopus and Google Scholar were searched for corresponding keywords. The initial search retrieved 770 articles of which 37 articles dealing with management, timing of surgery, complications or prognosis of ATCCS were identified. The literature review and draft position statements were compiled and circulated to panel members. The draft was modified incorporating relevant suggestions to reach consensus. Out of 37 studies, 15 were regarding management strategy, ten regarding timing of surgery and 12 regarding prognosis of ATCCS. There is reasonable evidence that patients with ATCCS secondary to vertebral fracture, dislocation, traumatic disc herniation or instability have better outcomes with early surgery (< 24 h). In patients of ATCCS secondary to extension injury in stenotic cervical canal without fracture/fracture dislocation/traumatic disc herniation/instability, there is requirement of high-quality prospective randomized controlled trials to resolve controversy regarding early surgery versus conservative management and delayed surgery if recovery plateaus or if there is a neurological deterioration. Until such time decision on surgery and its timing should be left to the judgment of physician, deliberating on pros and cons relevant to the particular patient and involving the well-informed patient and relatives in decision making. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown