Prospective study of omental transposition in patients with chronic spinal injury

J Neurol Neurosurg Psychiatry, 2001 · DOI: · Published: July 1, 2001

Simple Explanation

This study investigates the effectiveness of omental transposition for patients with chronic spinal cord injuries. Omental transposition involves transplanting a section of the greater omentum, a fatty tissue in the abdomen, to the injured spinal cord. The goal is to improve blood supply and potentially promote healing in the damaged spinal cord. The study assessed patients before and after the surgery, looking at various factors such as motor skills, sensation, and daily activities. The study found that omental transposition did not result in significant neurological improvement in these patients. The authors concluded that the continued use of this procedure for chronic spinal cord injury is not supported by their findings.

Study Duration

12 Months

Participants

17 patients with chronic spinal cord injuries

Evidence Level

Level 2; Prospective Study

Key Findings

1
The study found no statistically significant improvement in Ashworth spasticity scores, motor scores, sensory scores, Barthel ADL scores, or Frenchay scores after omental transposition.
2
Some patients showed minor subjective improvements, but these were not consistently observed or objectively measurable.
3
One patient experienced neurological deterioration after the procedure. There were also 20 surgical complications across the 17 patients.

Research Summary

This prospective study evaluated the efficacy of omental transposition in 17 patients with chronic spinal cord injuries. Patients underwent detailed neurological and functional assessments before and after surgery to determine the impact of the procedure. The results indicated that omental transposition did not lead to significant improvements in neurological function or functional abilities. Statistical analysis revealed no significant differences in spasticity, motor function, sensation, or activities of daily living. The authors concluded that omental transposition is not supported for routine use in chronic spinal cord injury and should be limited to experimental models. They suggest future research should focus on acute spinal cord injury.

Practical Implications

Limited Clinical Benefit

Omental transposition should not be considered a standard treatment for chronic spinal cord injury due to the lack of demonstrable neurological improvement.

Focus on Acute Injury

Further research should explore the potential benefits of omental transposition in the acute phase of spinal cord injury, possibly in conjunction with other regenerative therapies.

Cautious Surgical Approach

Clinicians should exercise caution when considering omental transposition for chronic spinal cord injury, given the potential for surgical complications and the absence of proven efficacy.

Study Limitations

1
Small sample size (17 patients)
2
Variability in patient characteristics (level and cause of injury, time since injury)
3
Potential for subjective bias in patient-reported outcomes

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