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  • Title: Efficacy of surgical decompression in regard to motor recovery in the setting of conus medullaris injury.
    Author: Rahimi-Movaghar V, Vaccaro AR, Mohammadi M.
    Journal: J Spinal Cord Med; 2006; 29(1):32-8. PubMed ID: 16572563.
    Abstract:
    BACKGROUND/OBJECTIVE: An assessment of neurological improvement after surgical intervention in the setting of traumatic conus medullaris injury (CMI). METHODS: A retrospective evaluation of a cohort of patients with a blunt traumatic CMI from T12 to L1. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data collected included age, level of injury, neurologic examination according to the Frankel grading system and motor index score, and the mechanism and timing of CMI decompression. RESULTS: A total of 24 patients with a mean age of 27 years (men, 87%) were identified. The most common level of bony injury was L1, and the most frequent mechanism of injury was a motor vehicle crash. Before surgical intervention, 16 of 24 patients (66.7%) had a complete neurological deficit below the level of injury. The median interval from injury to surgery was 6 days (range, 7 hours to 390 days). Decompression, fusion, and adjunctive internal fixation were the most common surgical procedures. Median length of follow-up was 32 months after surgery. Improvement in spinal cord and bladder function was seen in 41.6% and 63.6% of patients, respectively. Root recovery was seen in 83.3% of patients. CONCLUSIONS: In the setting of CMI, no correlation between the timing of surgical decompression and motor improvement was identified. Root recovery was more predictable than spinal cord and bladder recovery.
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