20.500.12556/RUL-165332 Thoracolumbar spinal cord injury management, techniques, timing Acute traumatic spinal cord injury (tSCI) is a complex and heterogeneous injury, where the level of injury, injury severity, duration and degree of spinal cord compression, and blood pressure management seem to influence neurologic outcome. Although data in the literature seem to be inconsistent regarding the effectiveness of surgical decompression and spinal fixation in patients with thoracic and thoracolumbar tSCI, some single-center studies suggest that early surgical decompression may lead to a superior neurologic outcome, especially in patients with incomplete tSCI, suggesting surgical decompression to be performed as soon as possible. However, high energy injuries, especially to the upper thoracic levels, may be too severe to be influenced by surgical decompression, which may represent a critical second hit for the polytraumatized patient. Therefore, the surgeon first needs to critically evaluate the potential for neurologic recovery in each patient before determining the ideal timing of surgery. Circulatory stabilization must be achieved before surgical intervention, and minimally invasive procedures should be preferred. Invasive blood pressure monitoring should be started on admission, and maintenance of a MAP between 85 and 90 mmHg is recommended for a duration of 5–7 days, with special attention to the prevention of hypoxia, fever, acidosis and deep venous thrombosis. The role of a 24-hour infusion of high-dose MPSS is still controversial, but it may be offered at the discretion of the treating surgeon to adult patients within 8 h of acute tSCI as a treatment option, especially in the case of very early decompression or incomplete tSCI. spinal cord injury thoracic spine thoracolumbar spine management timing decompression therapy poškodbe hrbtenjače terapija true false true Angleški jezik Slovenski jezik Članek v reviji 2024-12-02 14:24:53 2024-12-02 14:24:57 2024-12-03 04:01:00 0000-00-00 00:00:00 2024 0 0 Str. 1969-1975 iss. 5 Vol. 50 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 612.83:616-001 1863-9941 10.1007/s00068-024-02595-8 217227523 s00068-024-02595-8.pdf s00068-024-02595-8.pdf 1 40392C1C84D6E14794AC3AADB1C15CAC 2fd25b655d2c1bebfee97bc3603b46dbcdeb00a5745bccde2808deaaa0a7dfe7 983af614-b0b0-11ef-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=196438 https://link.springer.com/article/10.1007/s00068-024-02595-8 0 89e5edb2-b0b0-11ef-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=196437 Medicinska fakulteta 0 0 0