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Neurosurgical untethering with or without syrinx drainage results in high patient satisfaction and favorable clinical outcome in post-traumatic myelopathy patients

Holmström, Ulrika; Tsitsopoulos, Parmenion P.; Flygt, Hjalmar; Holtz, Anders and Marklund, Niklas LU (2018) In Spinal Cord 56(9). p.873-882
Abstract

Study design: Retrospective data collection and patient-reported outcome measures. Objectives: To investigate surgical outcome, complications, and patient satisfaction in patients with chronic SCI and symptomatic post-traumatic progressive myelopathy (PPM) who underwent neurosurgical untethering and/or spinal cord cyst drainage with the aim of preventing further neurological deterioration. Setting: Single-center study at an academic neurosurgery department. Methods: All SCI patients who underwent neurosurgery between 1996 and 2013 were retrospectively included. All medical charts and the treating surgeon’s operative reports were reviewed to identify surgical indications, surgical technique, and post-operative complications. A... (More)

Study design: Retrospective data collection and patient-reported outcome measures. Objectives: To investigate surgical outcome, complications, and patient satisfaction in patients with chronic SCI and symptomatic post-traumatic progressive myelopathy (PPM) who underwent neurosurgical untethering and/or spinal cord cyst drainage with the aim of preventing further neurological deterioration. Setting: Single-center study at an academic neurosurgery department. Methods: All SCI patients who underwent neurosurgery between 1996 and 2013 were retrospectively included. All medical charts and the treating surgeon’s operative reports were reviewed to identify surgical indications, surgical technique, and post-operative complications. A questionnaire and an EQ-5D-instrument were used to assess patient's self-described health status and satisfaction at long-term follow-up. Results: Fifty-two patients (43 men, 9 women) were identified, of whom five were dead and one was lost to follow-up. Main indications for surgery were pain (54%), motor (37%), or sensory (8%) impairment, and spasticity (2.0%). Overall complications were rare (8%). At follow-up, the subjectively perceived outcome was improved in 24 and remained unchanged in 21 patients. Thus, the surgical aim was met in 87% of patients. Of the 46 eligible patients, 38 responded to the questionnaire of whom 65% were satisfied with the surgical results. Patients with cervical lesions were more satisfied with the surgical treatment than patients with thoracic/thoracolumbar lesions (p = 0.05). Conclusions: Neurosurgical untethering and/or cyst drainage in chronic SCI patients and PPM resulted in a high degree of patient satisfaction, particularly in cervical SCI patients with minimal complications.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Spinal Cord
volume
56
issue
9
pages
873 - 882
publisher
Nature Publishing Group
external identifiers
  • scopus:85044450248
ISSN
1362-4393
DOI
10.1038/s41393-018-0094-y
language
English
LU publication?
yes
id
f9a8e5bd-8171-486b-b649-9cf3f0461add
date added to LUP
2018-05-22 12:53:42
date last changed
2019-01-14 17:25:24
@article{f9a8e5bd-8171-486b-b649-9cf3f0461add,
  abstract     = {<p>Study design: Retrospective data collection and patient-reported outcome measures. Objectives: To investigate surgical outcome, complications, and patient satisfaction in patients with chronic SCI and symptomatic post-traumatic progressive myelopathy (PPM) who underwent neurosurgical untethering and/or spinal cord cyst drainage with the aim of preventing further neurological deterioration. Setting: Single-center study at an academic neurosurgery department. Methods: All SCI patients who underwent neurosurgery between 1996 and 2013 were retrospectively included. All medical charts and the treating surgeon’s operative reports were reviewed to identify surgical indications, surgical technique, and post-operative complications. A questionnaire and an EQ-5D-instrument were used to assess patient's self-described health status and satisfaction at long-term follow-up. Results: Fifty-two patients (43 men, 9 women) were identified, of whom five were dead and one was lost to follow-up. Main indications for surgery were pain (54%), motor (37%), or sensory (8%) impairment, and spasticity (2.0%). Overall complications were rare (8%). At follow-up, the subjectively perceived outcome was improved in 24 and remained unchanged in 21 patients. Thus, the surgical aim was met in 87% of patients. Of the 46 eligible patients, 38 responded to the questionnaire of whom 65% were satisfied with the surgical results. Patients with cervical lesions were more satisfied with the surgical treatment than patients with thoracic/thoracolumbar lesions (p = 0.05). Conclusions: Neurosurgical untethering and/or cyst drainage in chronic SCI patients and PPM resulted in a high degree of patient satisfaction, particularly in cervical SCI patients with minimal complications.</p>},
  author       = {Holmström, Ulrika and Tsitsopoulos, Parmenion P. and Flygt, Hjalmar and Holtz, Anders and Marklund, Niklas},
  issn         = {1362-4393},
  language     = {eng},
  month        = {03},
  number       = {9},
  pages        = {873--882},
  publisher    = {Nature Publishing Group},
  series       = {Spinal Cord},
  title        = {Neurosurgical untethering with or without syrinx drainage results in high patient satisfaction and favorable clinical outcome in post-traumatic myelopathy patients},
  url          = {http://dx.doi.org/10.1038/s41393-018-0094-y},
  volume       = {56},
  year         = {2018},
}