The effect of decompressive laminectomy on neurologic recovery in spinal cord injury and spine fractures

Objective: In spinal cord injury, improved neurological recovery with early decompression has been demonstrated at several animal studies. Timing of decompressive surgery have been reported with different results in clinical trials. The comparison of the benefits of anterior and posterior decompressive surgical approach is an another issue which has been discussed extensively in the literature. We investigated the effect of decompressive laminectomy on recovery of neurological function in patients with spine fracture and spinal cord injury retrospectively.Materials and Methods: This study was conducted at Celal Bayar University Medical Faculty Hospital, Neurosurgery Department between January 2001-January 2010, to 71 patients that have emerge decompression with laminectomy and posterior stabilization operation after nonpenetrated spine fracture. 54 of these patients without additional neurological damage after head, abdominal or thoracic trauma, were enrolled retrospectively.Results: Traffic accidents are the leading cause of trauma in the etiology of patients (55,6 % motor vehicle accidents, falls 37%, motorcycle accidents 7,4% ). 77.77% of the patients included in the study were males (n = 42), and most commonly between 31?40 age (n = 18, 33.3%). ASIA score at admission to hospital was frequently ASIA B. Thoracolumbar segments was the most common region of the spine that exposed to trauma . In 6 of 8 patients (75,0%) with cervical injury, in 8 of 11 patients (72,7%) with thoracic injury and 14 of 24 patients (58,3%) with lumbar injury had neurological improvements in ASIA scores. Overall 65.1% of patients showed a statistically significant increase in the ASIA scores (n = 28, p <0.001). Healing in all trauma regions and the age group 20?50 were found significant (ages between 21?30 p=0,010, ages between 31?40 p=0,004, ages between 41?50 p=0,046).Conclusion: The results of our study shows that the laminectomy and posterior stabilization, increases neurological improvement. Posterior approach can be applied more quickly to patients with multiple trauma and can be finalized with fewer complications. Draining the epidural hematoma and repair of dural damage are the benefits of laminectomy.