Outcome of Early Spinal Decompression Combined with Damage Control Orthopaedics in High-Energy Trauma: A Prospective Cohort Study.
DOI:
https://doi.org/10.51168/jkhz4q60Keywords:
high-energy trauma, spinal injury, spinal decompression, damage control orthopaedics, ASIAAbstract
Background:
High-energy trauma is an important cause of spinal injury and may result in neurological deficits and substantial morbidity. Damage control orthopaedics (DCO) provides staged management of severely injured patients, while early spinal decompression may limit secondary spinal cord injury.
Objective:
To evaluate neurological recovery and postoperative complications following spinal decompression combined with DCO in patients with high-energy trauma and spinal injuries.
Methods:
A prospective cohort study was conducted at Patna Medical College and Hospital, Patna, Bihar, India. Fifty adult patients with high-energy trauma and spinal injuries were included. Patients underwent spinal decompression and DCO-based management according to their clinical condition. Neurological status was assessed using the American Spinal Injury Association (ASIA) grading system. Postoperative complications were recorded, and outcomes were analyzed according to surgical timing.
Results:
Of 50 patients, 38 (76%) were male, and 12 (24%) were female, with a mean age of 35 ± 10 years. Neurological improvement occurred in 32 patients (64%). Improvement was observed in 16/20 (80%) patients undergoing surgery within 24 hours, compared with 12/18 (66.7%) within 24–72 hours and 4/12 (33.3%) after 72 hours (p = 0.03). Postoperative complications occurred in 20 patients (40%), including infection (16%), pulmonary complications (14%), and deep vein thrombosis (10%).
Conclusion:
Earlier spinal decompression was associated with greater neurological improvement in this cohort.
Recommendation:
Timely multidisciplinary trauma assessment and appropriately selected early decompression should be considered. Larger prospective studies are needed.
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