Citation

Abbas A, Aziz HF, Rizvi R, Rehman L, Javeed F, Afzal A. Turk. Neurosurg. 2019; 29(4): 506-512.

Affiliation

Jinnah Postgraduate Medical Centre.

Copyright

(Copyright © 2019, Turkish Neurosurgical Society)

DOI

10.5137/1019-5149.JTN.24121-18.2

PMID

30649823

Abstract

AIM: Gunshot acquired spinal cord injury is one of leading cause of disability in young population with debatable management protocols. We intend to understand the outcome of operative versus conservative approach based on ASIA impairment scale Material and Methods: One hundred and sixty eight patients were analyzed for this retrospective study. AIS of all the consenting survivors after emergence from the spinal shock were recorded along with demographical variables and level of injury. Patients were divided based on their management approach and outcome was measured via AIS score on six months follow up. Univariate statistics were applied to establish significance of results.

RESULTS: Male constituted 91.6% of this study with mean age of 26+4.2years. Majority (73.2%) of patients had incomplete spinal cord injury. Most of the complete spinal injury occurred in thoracic spine (84%) that was involved in half of the cases of this series (51%). Twenty six (15.4%) patients underwent operative intervention. Distribution of patients in groups (operative versus non-operative) was different on AIS. AIS on follow up significantly differ from AIS on admission among each group (p value 0.001) however in comparison, the change in AIS on follow up was not significantly different between the two groups (p value 0.05).

CONCLUSION: None of the management approach is superior in terms of neurological recovery. Despite that appropriate selection of surgical candidates is the key to serve this narrow spectrum benefit of improve outcome in these young patients.

Language: en