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Indications for Emergency Surgical Treatment

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Spine Surgery

Abstract

Indications to emergency surgical treatment in degenerative spinal conditions are limited to those conditions where a delay in surgical management may lead to potentially catastrophic and irreversible sequelae. Indeed, those conditions are rarely encountered during clinical practice. The most typical scenarios in the thoraco-lumbar region are cauda equina syndrome (CES) and progressive radicular motor deficit (PRMD), both primarily caused by degenerative lumbar pathology. Early surgical treatment may influence the partial or full recovery and the long-term outcome of concerned patients.

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References

  1. Fraser S, Roberts L, Murphy E. Cauda equina syndrome: a literature review of its definition and clinical presentation. Arch Phys Med Rehabil. 2009;90(11):1964–8.

    Article  Google Scholar 

  2. Council MR. Aids to the examination of the peripheral nervous system Memorandum No. 45 (superseding War Memorandum No. 7). Her Majesty’s stationary office. 1976.

    Google Scholar 

  3. Ahn UM, Ahn NU, Buchowski JM, Garrett ES, Sieber AN, Kostuik JP. Cauda equina syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes. Spine (Phila Pa 1976). 2000;25(12):1515–22.

    Article  CAS  Google Scholar 

  4. Korse NS, Veldman AB, Peul WC, Vleggeert-Lankamp CLA. The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome. PLoS One. 2017;12(4):e0175987.

    Article  Google Scholar 

  5. Arts MP, Peul WC, Koes BW, Thomeer RT, Leiden-The Hague Spine Intervention Prognostic Study (SIPS) Group. Management of sciatica due to lumbar disc herniation in the Netherlands: a survey among spine surgeons. J Neurosurg Spine. 2008;9(1):32–9.

    Article  Google Scholar 

  6. Overdevest GM, Vleggeert-Lankamp CL, Jacobs WC, Brand R, Koes BW, Peul WC, Leiden-The Hague Spine Intervention Prognostic Study Group. Recovery of motor deficit accompanying sciatica--subgroup analysis of a randomized controlled trial. Spine J. 2014;14(9):1817–24.

    Article  Google Scholar 

  7. Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245–56.

    Article  CAS  Google Scholar 

  8. Takenaka S, Aono H. Prediction of postoperative clinical recovery of drop foot attributable to lumbar degenerative diseases, via a Bayesian network. Clin Orthop Relat Res. 2017;475(3):872–80.

    Article  Google Scholar 

  9. Macki M, Syeda S, Kerezoudis P, Gokaslan ZL, Bydon A, Bydon M. Preoperative motor strength and time to surgery are the most important predictors of improvement in foot drop due to degenerative lumbar disease. J Neurol Sci. 2016;361:133–6.

    Article  Google Scholar 

  10. Aono H, Nagamoto Y, Tobimatsu H, Takenaka S, Iwasaki M. Surgical outcomes for painless drop foot due to degenerative lumbar disorders. J Spinal Disord Tech. 2014;27(7):E258–61.

    Article  Google Scholar 

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Correspondence to Max Jägersberg .

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Jägersberg, M., Tessitore, E. (2019). Indications for Emergency Surgical Treatment. In: Meyer, B., Rauschmann, M. (eds) Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98875-7_2

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  • DOI: https://doi.org/10.1007/978-3-319-98875-7_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98874-0

  • Online ISBN: 978-3-319-98875-7

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