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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e586-e591
DOI: 10.1055/s-0043-1772240
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Timing of Surgery and Pre-operative Physiological Parameters as Clinical Predictors of Surgical Outcomes in Traumatic Subaxial Cervical Spine Fractures and Dislocations

Article in several languages: português | English
Aman Khanna 
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
,
Hari Menon
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
,
Vijay Chaudhary
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
,
Pratik Sidhdhapuria
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
,
Kandarp Patel
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
,
Chandan Narang
1   Ortopedista e Traumatologista, Departamento de Ortopedia, New Civil Hospital Surat, Gujarat, Índia
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Financial Support There was no financial support from public, commercial, or non-profit sources.
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Abstract

Objective To evaluate the risk factors and outcomes in patients surgically treated for subaxial cervical spine injuries with respect of the timing of surgery and preoperative physiological parameters of the patient.

Methods 26 patients with sub-axial cervical spine fractures and dislocations were enrolled. Demographic data of patients, appropriate radiological investigation, and physiological parameters like respiratory rate, blood pressure, heart rate, PaO2 and ASIA impairment scale were documented. They were divided pre-operatively into 2 groups. Group U with patients having abnormal physiological parameters and Group S including patients having physiological parameters within normal range. They were further subdivided into early and late groups according to the timing of surgery as Uearly, Ulate, Searly and Slate. All the patients were called for follow-up at 1, 6 and 12 months.

Results 56 percent of patients in Group S had neurological improvement by one ASIA grade and a good outcome irrespective of the timing of surgery. Patients in Group U having unstable physiological parameters and undergoing early surgical intervention had poor outcomes.

Conclusion This study concludes that early surgical intervention in physiologically unstable patients had a strong association as a risk factor in the final outcome of the patients in terms of mortality and morbidity. Also, no positive association of improvement in physiologically stable patients with respect to the timing of surgery could be established.

Keywords

cervical vertebrae - operative time - risk factors - prospective studies

Authors' Contributions

Each author contributed individually and significantly to the development of this article: AK - Principal investigator of the study and author. HM - Operating surgeon and co-author. VC - Care of the patients included in the study and editing of manuscript. PS, KP and CN – Care of the Patient.


Work developed in the Department of Orthopaedics, New Civil Hospital Surat, Gujarat, India.




Publication History

Received: 14 February 2022

Accepted: 05 May 2023

Article published online:
30 August 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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