EFFECTIVENESS OF SURGICAL TREATMENT FOR SPINAL CORD INJURY WITHOUT RADIOGRAPHIC EVIDENCE OF TRAUMA IN GERIATRIC PATIENTS

Abstract

　　Objectives : We report the outcomes of aggressive early surgical treatment for spinal cord injury without radiographic evidence of trauma (SCIWORET) in geriatric patients. Methods : SCIWORET patients with an American Spinal Injury Association Impairment Scale (AIS) grade of A to C and magnetic resonance imaging-confirmed spinal cord compression were included in this study. Decompression surgery was performed as early as possible. Results : Fifty-nine patients with SCIWORET were included and 57 underwent decompression surgery. The mean age was 78.2 years. There were 13 patients with AIS grade A, 8 with grade B, and 36 with grade C. The median time from injury to surgery was 9 hours and the median hospital stay was 46 days. The in-hospital mortality rate was 8.8% (5/57). Forty patients (70.2%) improved by at least 1 AIS grade during hospitalization and 7 (12.3%) improved by at least 2 grades. Conclusion : Even in geriatric patients, early surgery can reduce mortality and improve the functional prognosis.