Hidetomo Nakamura

Emergency Operation for Spinal Diseases

There are few reports on the prognosis of emergency operations for spinal diseases. We investigated the prognosis of emergency operations. Twenty-nine out of 632 patients with spinal diseases, who were operated during the fifteen years between 1998 and 2003, were treated by emergency operations. These patients were followed up for an average of one and a half years. Operations were performed for the following diseases; nine lumbar disc herniations, four spinal epidural hematomas, three spinal tumors, three spinal fractures, two osteoporotic vertebral fractures, one cervical disc herniation, one lumbar canal stenosis, and five pyogenic spondylitis with sepsis. When operations were performed 24 hours from paralysis, the dysuria or sepsis occured. Nineteen patients showed paralysis, 13 of which improved. Lumbar disc degenerative diseases and spinal epidural hematomas tended to improved better than the spinal fractures. Fifteen patients showed dysuria, 9 of which improve. Four out of five pyogenic spondylitis improved, and the remaining one with secondary pyogenic spondylitis after posterior spinal fusion with instrumentation needed further closed suction irrigation. Emergency operation was effective for paralysis, dysuria, and severe inflammation. The indication should be considered depending on disease.