Evidence map›Paper›PMID 30215287›Full record

ArticleJournal of neurotrauma2019

Extent of Spinal Cord Decompression in Motor Complete (American Spinal Injury Association Impairment Scale Grades A and B) Traumatic Spinal Cord Injury Patients: Post-Operative Magnetic Resonance Imaging Analysis of Standard Operative Approaches.

Bizhan Aarabi, Joshua Olexa, Timothy Chryssikos, Samuel M Galvagno, David S Hersh, Aaron Wessell, Charles Sansur, Gary Schwartzbauer, Kenneth Crandall, Kathirkamanathan Shanmuganathan and 10 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurotrauma, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it, 91 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 2 institutions in 1 country.

Bizhan Aarabi1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Joshua Olexa1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Timothy Chryssikos1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Samuel M Galvagno2 Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.
David S Hersh1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Aaron Wessell1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Charles Sansur1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Gary Schwartzbauer1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Kenneth Crandall1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Kathirkamanathan Shanmuganathan3 R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
J Marc Simard1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Harry Mushlin1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Mathew Kole1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Elizabeth Le1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Nathan Pratt1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Gregory Cannarsa1 Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Cara D Lomangino3 R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
Maureen Scarboro3 R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
Carla Aresco3 R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
Brian Curry5 Walter Reed National Military Medical Center, Bethesda, Maryland.
University of Maryland, Baltimore · USWalter Reed National Military Medical Center · US

Funding

Spinal cord injury, progressive hemorrhagic necrosis and the NC(Ca-ATP) channelR01NS060801 · NINDS · UNIVERSITY OF MARYLAND BALTIMORE · PI SIMARD, J. MARC · 2009 to 2018
$3.3M
NINDS NIH HHS R01 NS060801
6 · The paper itself

Abstract

Although decompressive surgery following traumatic spinal cord injury (TSCI) is recommended, adequate surgical decompression is rarely verified via imaging. We utilized magnetic resonance imaging (MRI) to analyze the rate of spinal cord decompression after surgery. Pre-operative (within 8 h of injury) and post-operative (within 48 h of injury) MRI images of 184 motor complete patients (American Spinal Injury Association Impairment Scale [AIS] grade A = 119, AIS grade B = 65) were reviewed to verify spinal cord decompression. Decompression was defined as the presence of a patent subarachnoid space around a swollen spinal cord. Of the 184 patients, 100 (54.3%) underwent anterior cervical discectomy and fusion (ACDF), and 53 of them also underwent laminectomy. Of the 184 patients, 55 (29.9%) underwent anterior cervical corpectomy and fusion (ACCF), with (26 patients) or without (29 patients) laminectomy. Twenty-nine patients (16%) underwent stand-alone laminectomy. Decompression was verified in 121 patients (66%). The rates of decompression in patients who underwent ACDF and ACCF without laminectomy were 46.8% and 58.6%, respectively. Among these patients, performing a laminectomy increased the rate of decompression (72% and 73.1% of patients, respectively). Twenty-five of 29 (86.2%) patients who underwent a stand-alone laminectomy were found to be successfully decompressed. The rates of decompression among patients who underwent laminectomy at one, two, three, four, or five levels were 58.3%, 68%, 78%, 80%, and 100%, respectively (p < 0.001). In multi-variate logistic regression analysis, only laminectomy was significantly associated with successful decompression (odds ratio 4.85; 95% confidence interval 2.2-10.6; p < 0.001). In motor complete TSCI patients, performing a laminectomy significantly increased the rate of successful spinal cord decompression, independent of whether anterior surgery was performed.

Indexed as

AdultCervical CordDecompression, SurgicalDiskectomyFemaleHumansLaminectomyMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesSpinal Cord InjuriesSpinal FusionASIA Impairment ScaledecompressionMRIspinal cord injurytrauma

Identifiers

PMID30215287
PMCPMC6484360
OpenAlexW2891822060

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.