Experience with a spinal cord unit in Brasilia, Brazil

We have analysed our experiences in a Spinal Cord Unit in Brasilia, Brazil in the last 5 years (1982-1986). There were 738 outpatients and 243 inpatients. One hundred and six patients were operated on by the neurosurgical staff, and the indications for operation are discussed. Some patients showed neurological recovery with surgery and some without surgery. Patients with a complete neurological deficit on admission did not show any improvement, and those with a severe but incomplete deficit showed improvement with surgery (18%), which was better than those without an operation. We conclude that a surgical procedure seems to be indicated in those with a comminuted, or with an unstable fracture, if there is an incomplete neurological deficit with an unreduced spinal deformity. There was a possibility of recovery of some nerve root function. The goal of surgical treatment is to restore and maintain the anatomical relationships between the spinal canal, spinal cord and nerve roots with the simplest possible surgical procedure, returning the patient as soon as possible to his functional capacity and social life.