Article Figures & Data
Tables
Personal Data n % Specialty Neurosurgery 60 61.2% Orthopedics 38 38.8% School of training European 21 21.4% Local 21 21.4% North American 56 57.1% Dedicated spine fellowship Yes 53 54.1% No 45 45.9% Time in practice, y <5 y 23 23.5% 5–10 y 20 20.4% >10 y 55 56.1% Where do you practice currently? MOH government hospital 41 41.8% MOH private hospital 40 40.8% National guard hospital 15 15.3% University hospital 16 16.3% Military hospital 11 11.2% King Faisal Specialist Hospital & Research Center 5 5.1%a Annual number of acute spinal cord injury cases you manage <10 50 51.0% 10–20 23 23.5% >20 25 25.5% Abbreviations: MOH, Ministry of Health.
↵a Some surgeons work in more than 1 hospital.
- Table 2
Spine surgeon traumatic spinal cord injury–related practice differences based on specialty.
Practice Regarding Spinal Cord Injuries Total (%) Specialty P Value Neurosurgery Orthopedics n % n % Use of steroid 0.506 I never give steroids 43 (43.9%) 27 45.0% 16 42.1% I give if injury is less than 8 h 23 (23.5%) 13 21.7% 10 26.3% I give if injury is less than 24 h 21 (21.4%) 15 25.0% 6 15.8% I give regardless of time of the injury 11 (11.2%) 5 8.3% 6 15.8% Duration of steroid treatment 0.422 1 dose 7 (12.7%) 3 9.1% 4 18.2% Up to 12 h 1 (1.8%) 0 0.0% 1 4.5% Up to 24 h 24 (43.6%) 16 48.5% 8 36.4% Up to 48 h 23 (41.8%) 14 42.4% 9 40.9% Steroid drug used 0.500 Dexamethasone 22 (40%) 12 36.4% 10 45.5% Methylprednisolone sodium succinate 33 (60%) 21 63.6% 12 54.5% Admission to high-dependency unit 0.417 All cases 34 (34.7%) 23 38.3% 11 28.9% Only cervical cord injury 40 (40.8%) 24 40.0% 16 42.1% Depends on availability of beds 16 (16.3%) 10 16.7% 6 15.8% None 8 (8.2%) 3 5.0% 5 13.2% Maintenance of the mean arterial pressure in a certain range 0.029a Yes 78 (79.6%) 52 86.7% 26 68.4% No 20 (20.4%) 8 13.3% 12 31.6% Early spinal cord decompression 0.349 I always do decompression in less than 24 h of the injury 58 (59.2%) 33 55.0% 25 65.8% I believe in early decompression, but the facility does not allow this practice 16 (16.3%) 13 21.7% 3 7.9% Whenever operating room time is available 15 (15.3%) 9 15.0% 6 15.8% I don’t believe that early decompression adds a neurological benefit 9 (9.2%) 5 8.3% 4 10.5% ↵a P < 0.05 (significant).
- Table 3
Spine surgeon traumatic spinal cord injury practice differences based on school of training.
Practice Regarding Spinal Cord Injuries School of Training P Value Local European North American n % n % n % Your practice regarding giving steroids in acute spinal cord–injured patient 0.049a I never give steroids 6 28.6% 9 42.9% 28 50.0% I give if injury is less than 8 h 6 28.6% 3 14.3% 14 25.0% I give if injury is less than 24 h 8 38.1% 5 23.8% 8 14.3% I give regardless of time of the injury 1 4.8% 4 19.0% 6 10.7% If you give steroids, how long do you keep the patient on it? 0.834 1 dose 1 6.7% 2 16.7% 4 14.3% Up to 12 h 0 0.0% 0 0.0% 1 3.6% Up to 24 h 8 53.3% 6 50.0% 10 35.7% Up to 48 h 6 40.0% 4 33.3% 13 46.4% Steroid medication administered 0.676 Dexamethasone 5 33.3% 6 50.0% 11 39.3% Methylprednisolone sodium succinate 10 66.7% 6 50.0% 17 60.7% Do you admit isolated spinal cord injury patients in the high-dependency unit? 0.307 Yes, all of them 5 23.8% 4 19.0% 25 44.6% Only cervical cord injury 10 47.6% 12 57.1% 18 32.1% Depends on availability of beds 4 19.0% 4 19.0% 8 14.3% None of them 2 9.5% 1 4.8% 5 8.9% Do you aim to keep the mean arterial pressure in a certain range? 0.044a Yes 18 85.7% 13 61.9% 47 83.9% No 3 14.3% 8 38.1% 9 16.1% Do you try to do early decompression? 0.427 I always do decompression in less than 24 h of the injury 11 52.4% 11 52.4% 36 64.3% I believe in early decompression, but the facility does not allow this practice 6 28.6% 2 9.5% 8 14.3% Whenever operating room time is available 2 9.5% 5 23.8% 8 14.3% I don’t believe early decompression adds neurological benefit 2 9.5% 3 14.3% 4 7.1% ↵a P < 0.05 (significant).
- Table 4
Spine surgeon traumatic spinal cord injury practice differences based on spine fellowship.
Practice Regarding Spinal Cord Injuries Dedicated Spine Fellowship P Value Yes No n % n % Your practice regarding giving steroids in acute spinal cord–injured patient 0.098 I never give steroids 29 54.7% 14 31.1% I give if injury is less than 8 h 10 18.9% 13 28.9% I give if injury is less than 24 h 8 15.1% 13 28.9% I give regardless of time of the injury 6 11.3% 5 11.1% If you give steroids, how long you keep patient on it? 0.390 1 dose 3 12.5% 4 12.9% Up to 12 h 1 4.2% 0 0.0% Up to 24 h 8 33.3% 16 51.6% Up to 48 h 12 50.0% 11 35.5% Steroid medication administered 0.824 Dexamethasone 10 41.7% 12 38.7% Methylprednisolone sodium succinate 14 58.3% 19 61.3% Do you admit isolated spinal cord injury patients in high-dependency unit? 0.308 Yes, all of them 21 39.6% 13 28.9% Only cervical cord injury 19 35.8% 21 46.7% Depends on availability of beds 7 13.2% 9 20.0% None of them 6 11.3% 2 4.4% Do you aim to keep the mean arterial pressure in a certain range? 0.681 Yes 43 81.1% 35 77.8% No 10 18.9% 10 22.2% Do you try to do early decompression? 0.478 I always do decompression in less than 24 h of the injury 31 58.5% 27 60.0% I believe in early decompression, but the facility does not allow this practice 8 15.1% 8 17.8% Whenever operating room time is available 7 13.2% 8 17.8% I don’t believe early decompression adds neurological benefit 7 13.2% 2 4.4% - Table 5
Spine surgeon traumatic spinal cord injury practice differences based on years of practice.
Practice Regarding Spinal Cord Injuries Years You Have Been in Practice P Value <5 y 5–10 y >10 y n % n % n % Your practice regarding giving STEROIDS in acute spinal cord–injured patient 0.657 I never give steroids 12 52.2% 7 35.0% 24 43.6% I give if injury is less than 8 h 5 21.7% 4 20.0% 14 25.5% I give if injury is less than 24 h 3 13.0% 5 25.0% 13 23.6% I give regardless of time of injury 3 13.0% 4 20.0% 4 7.3% If you give steroids, how long you keep patient on it? 0.011a 1 dose 0 0.0% 1 7.7% 6 19.4% Up to 12 h 1 9.1% 0 0.0% 0 0.0% Up to 24 h 3 27.3% 3 23.1% 18 58.1% Up to 48 h 7 63.6% 9 69.2% 7 22.6% Steroid medication administered 0.168 Dexamethasone 6 54.5% 7 53.8% 9 29.0% Methylprednisolone sodium succinate 5 45.5% 6 46.2% 22 71.0% Do you admit isolated spinal cord injury patients in high-dependency unit? 0.049a Yes, all of them 14 60.9% 7 35.0% 13 23.6% Only cervical cord injury 7 30.4% 7 35.0% 26 47.3% Depends on availability of beds 2 8.7% 3 15.0% 11 20.0% None of them 0 0.0% 3 15.0% 5 9.1% Do you aim to keep the mean arterial pressure in a certain range? 0.279 Yes 21 91.3% 15 75.0% 42 76.4% No 2 8.7% 5 25.0% 13 23.6% Do you try to do early decompression? 0.390 I always do decompression in less than 24 h of the injury 18 78.3% 11 55.0% 29 52.7% I believe in early decompression, but the facility does not allow this practice 2 8.7% 3 15.0% 11 20.0% Whenever operating room time is available 3 13.0% 3 15.0% 9 16.4% I don’t believe early decompression adds neurological benefit 0 0.0% 3 15.0% 6 10.9% ↵a P < 0.05 (significant).
- Table 6
Spine surgeon traumatic SCI practice differences based on the number of cases managed per year.
Practice Regarding SCIs Number of Cases of Acute SCI You Manage per Year P Value <10 10–20 >20 No % No % No % Your practice regarding giving steroids in an acute SCI patient 0.528 I never give steroids 20 40.0% 9 39.1% 14 56.0% I give if injury is less than 8 h 12 24.0% 5 21.7% 6 24.0% I give if injury is less than 24 h 11 22.0% 5 21.7% 5 20.0% I give regardless of time of the injury 7 14.0% 4 17.4% 0 0.0% If you give steroids, how long do you keep the patient on it? 0.191 1 dose 6 20.0% 1 7.1% 0 0.0% Up to 12 h 0 0.0% 1 7.1% 0 0.0% Up to 24 h 13 43.3% 4 28.6% 7 63.6% Up to 48 h 11 36.7% 8 57.1% 4 36.4% Steroid medication administered 0.628 Dexamethasone 13 43.3% 6 42.9% 3 27.3% Methylprednisolone sodium succinate 17 56.7% 8 57.1% 8 72.7% Do you admit isolated SCI patients in high-dependency unit? 0.029a Yes, all of them 22 44.0% 7 30.4% 5 20.0% Only cervical cord injury 16 32.0% 14 60.9% 10 40.0% Depends on availability of beds 6 12.0% 2 8.7% 8 32.0% None of them 6 12.0% 0 0.0% 2 8.0% Do you aim to keep the mean arterial pressure in a certain range? 0.550 Yes 41 82.0% 19 82.6% 18 72.0% No 9 18.0% 4 17.4% 7 28.0% Do you try to do early decompression? 0.324 I always do decompression in less than 24 h of the injury 32 64.0% 15 65.2% 11 44.0% I believe in early decompression, but the facility does not allow this practice 6 12.0% 3 13.0% 7 28.0% Whenever operating room time is available 6 12.0% 3 13.0% 6 24.0% I don't believe early decompression adds neurological benefit 6 12.0% 2 8.7% 1 4.0% Abbreviations: SCI, spinal cord injury;
↵a P < 0.05 (significant).
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.