Journal of Orthopedics & Rheumatology
Research Article
Is there an Increase in Intra-operative Bleeding during Emergency Hybrid Open-Door Laminoplasty for Posttraumatic Cervical Cord Patients?
Liu G*, Lee BH, Tan JYW, Ng JH and Tan JH
Department of Orthopaedics, Hand and Reconstructive Microsurgical Cluster, National University Health System, Singapore
*Address for Correspondence: Liu G, MBBCh, MSc, FRCS, FRCSEd(Orth), Head, Spine Surgery Division, University Orthopaedics, Hand and Reconstructive Microsurgical
Cluster, National University Health System, Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 11, Singapore 119228, Tel: +65 92338520, Fax: +65 67780420; E-mail: gabriel_liu@nuhs.edu.sg
Submission: 04 October 2021;
Accepted: 05 November 2021;
Published: 10 November 2021
Copyright: © 2020 Liu G, et al. This is an open access article distributed
under the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.
Abstract
Study Design: Retrospective Cohort Study
Objectives: There are no reports describing the potential increase in
intra-operative blood loss with the use of hybrid open-door laminoplasty
in post-traumatic cervical cord injuries.
Summary of background data: Early surgical intervention for
traumatic cervical cord injury has demonstrated outcome benefits but
is not without complications.
Methods: A retrospective review of patients who underwent open door
hybrid laminoplasty by a single surgeon was performed. Patients
were divided into 2 groups- Group A: isolated traumatic spinal cord
injury without vertebral fracture, Group B: non-traumatic spinal cord
injury.
Results: 30 consecutive patients, of whom 8 had isolated traumatic
cervical injury, underwent hybrid open-door laminoplasty. A longer
mean operative time (254 vs 199 minutes, p=0.005), hospital stay (44.1
vs 11.1 days, p=0.006) and ICU or high dependency unit stay (10.3 vs 1.5
days, p=0.004) was noted in the traumatic patients when compared to
the non-traumatic patients. A greater amount of intraoperative blood
loss was found in the traumatic patients (median 350 ml; range 110-750)
and less in the non-traumatic patients (median 130 ml; range 50-400,
p=0.032). Patients in both groups showed post-operative neurological
recovery with a JOA score improvement of 1.9 ± 3.1 (p=0.14) in the
traumatic group and 1.4 ± 1.7 (p=0.001) in the non-traumatic group.
Conclusions: Emergency open-door hybrid laminoplasty can
be performed in patients with traumatic spinal cord injury. While
early surgical decompression for post-traumatic patients improves
neurological outcomes, a higher intra-operative bleeding should be
anticipated in post-traumatic patients