SURGICAL TREATMENT OF SPINAL CORD INJURY

PREVENTION OF SECONDARY DAMAGE IN THE ACUTE STAGE AND FUNCTIONAL RESTORATION IN THE CHRONIC STAGE

Abstract

The Protocol for treatment of central nervous system injury was evaluated with consideration given to the goal of preserving neuronal integrity as well as future functional restoration. A case involving injury to the spinal cord is presented. There was associated cervical spinal canal stenosis and the patient was treated with high-dose methylprednisolone as well as an expansive laminoplasty. This was performed in an effort to prevent secondary spinal cord damage during the acute and subacute stages.
Functinal electrical stimulation (FES) was performed for the neurologic (motor) deficits of the right upper extremity, in the chronic stage. Following methylprednisolone therapy, the severe tetraparesis showed significant recovery with subsequent further improvement being achieved after the laminoplasty. Persistent motor deficits of the hand were restored by utilizing FES, after 5 weeks of exercises. It was concluded that the results of these procedures were very encouraging. Further trials should be performed. Both basic science and clinical studies will be required to further efforts in achieving effective functional restoration following injury to the brain and/or spinal cord.