Treatment Strategy Selection And Clinical Efficacy Of Midaged Atypical Central Cord Injury Without Fracture Or Dislocation

Objective To analyze the cause and the injury mechanism of the wrinkly atypical central cord injury without fracture or dislocation(CSCIWFD),and discuss the MRI characteristics,surgical approach selection,timing of surgery and surgical outcomeMethods.Fifty-two elderly patients with CSCIWFD who underwent surgical treatment and were followed up from January 2014 to December 2015 were selected as subjects.Patients were divided into 3 groups with regard to the timing of surgery after injury: those undergoing early surgery(less than 24 hours after injury),those undergoing late surgery(more than 24 hours after injury but during initial admission to the hospital and within 3 weeks from injury),and those undergoing delayed surgery(during second admission to the hospital,within 3 months but later than 3 weeks from injury).Seventeen patients underwent early surgery,22 underwent late surgery,and 13 underwent delayed surgery.The neurologic status of patients was assessed using the ASIA score and JOA scoreResults.Mean follow-up was(15.03±6.39)months(range,5-33 months).compared with pre-treatment,the JOA score and ASIA exercise score were significantly higher in the early surgery group,the late operation group and the delayed operation group at the last follow-up(P<0.05),but no significant difference in recovery rate was found between the groups with regard to the timing of surgery(P>0.05).Conclusion:This retrospective study supports the notion that surgical decompression is effective in the treatment of patients with CSCIWFD.Timing of surgery(less than 3 months)was not significantly associated with neurologic recovery.Conclusion Rehabilitation therapy combined with pelvic floor muscle training could provide great efficacy for patients suffering from urinary stressing incontinence during early postpartum period,which was worth clinical application and promotion.