THORACIC SPINAL TRAUMA AND ASSOCIATED INJURIES - SHOULD EARLY SPINAL DECOMPRESSION BE CONSIDERED

The relative benefits of conservative or surgical treatment in thoraci c spinal trauma are still controversial, Owing to its anatomic relatio ns, thoracic spinal trauma is specific regarding neurologic prognosis, the high incidence of associated injuries, and surgical management, O ver a 30-month period, 49 patients sustained thoracic spinal trauma wi th neurologic impairment, The authors review population characteristic s, associated injuries, and surgical management, and underline the hig h incidence of associated injuries, in particular, blunt chest trauma, In their opinion, early spinal decompression has no indication in com plete paraplegia. Concerning partial paraplegia, early surgery may enh ance neurologic recovery, Nevertheless, they suggest three main criter ia in deciding whether or not to perform surgery early: the existence of residual spinal compression, the degree of neurologic impairment, a nd the presence of potential hemorrhagic lesions or blunt chest trauma , especially pulmonary contusion.