Analysis Of Factors Associated With Spinal Cord Injury Aggravated In Progressive Spinal Cord Compression

Objective(s):1.To investigate the risk factors of spinal cord injury caused by progressive spinal cord compression and the aggravation of postoperative spinal cord injury;2.To analyze the clinical value of steroids in spinal cord injury patients undergoing spinal cord compression surgery;3.To provide references for the treatment of spinal cord compression lesions and the recovery of neurological function in the clinic?Methods:Case data:the clinical data of patients with spinal cord compression lesions treated in our department from June 2014 to February-2017 were collected and analyzed before and after operation.According to the study design criteria,229 patients were included in the study.All patients underwent posterior midline approach,laminectomy,lesion removal,spinal decompression,laminectomy,and spinal canal remodeling.The above operation by our department of intraspinal lesions of skilled physicians and deputy chief physician and associate chief physician with titles above the anesthesiologist completed.229 patients were not treated until the end of the follow-up.According to factors that may affect the spinal cord injury:the relative position and age,gender,tumor degree of spinal cord compression is greater than the diameter of the spinal 1/2,intraoperative hormone use,and spinal cord tumor invasion were single factor analysis.Univariate analysis of the significance of the change into the unconditional multi factor Logistic regression model for multivariate analysis,P<0.05 for the difference was statistically significant.Multi factor Logistic regression model for multivariate analysis showed that the invasive degree of spinal cord compression is greater than the diameter of the spinal canal,spinal cord by 1/2 age,location and stage of tumor oppression and relatively independent risk factors,and analysis of comparative study on spinal cord injury in different groups within the period change of JOA score increase before and after surgery the change of JOA score and hormone use study group.Statistical data processing:all data were analyzed by SPSS 22 statistical software.JOA scores were used to assess neurological changes before and after spinal cord injury.Results:229 cases were analyzed for evaluation and follow-up of hospitalization,postoperative spinal cord injury in 32 cases,the incidence rate of 13.97%;according to the JOA standard for evaluation,32 cases of spinal cord injury patients with preoperative JOA score was 14.6±1.8,after 1 month follow-up JOA score was 12.2±1.2,statistical analysis.P<0.05,with statistical significance.Single factor analysis of gender,drainage factors and segmental lesions,P>0.05,the difference was not statistically significant;P<0.05 age,degree of spinal cord compression,whether the tumor is located in the ventral spinal cord and other factors,and the difference was statistically significant.Multi factor Logistic regression model for multivariate analysis:age,spinal cord compression,severe lesions in the ventral and invasive lesions are statistically significant differences in risk factors after spinal cord injury aggravated(P<0.05).The JOA scores of different periods in the hormone usage study group were analyzed by group analysis(P<0.05),and the difference was statistically significant.Conclusion(s):1.In progressive spinal cord compression diseases,when the pressure exceeds 1/2 in the diameter of the spinal canal,the spinal cord injury is serious before and after the operation,and the recovery of the neurological function is poor and the time is long,which confirms the value of early treatment.2.The rational use of hormone is important for the recovery of spinal cord function after spinal cord compression,especially for large tumor volume,severe spinal cord compression,and tumor located on the ventral and ventrolateral sides.3.The nature,location and location of spinal cord compression lesions are different,and the spinal cord injuries are different after operation.4.Careful,delicate and precise surgical techniques and experience are necessary for the management of intraspinal spinal cord lesions,especially in the removal of ventral and invasive tumors.