Analysis of the factors associated with treatment outcomes in spinal cord decompression sickness

Abstract

Objective To analyze the factors associated with treatment outcomes of dive-related spinal cord decompression sickness (DCS). Methods A retrospective analysis was made in 95 patients with dive-related spinal cord DCS (with an age range of 43±11). Such medical data as dive data, clinical medical data, spinal cord magnetic resonance imaging (MRI), electrophysiological data, latency of DCS symptoms upon completion of diving, the relationship between symptom onset and the interval from the start of HBO therapy to the termination of HBO therapy were collected for analysis. The severity and treatment outcomes of spinal cord DCS were assessed by the Boussuges grade system during the acute stage and 3 months after treatment. The treatment outcomes of spinal cord DCS were classified into complete recovery and incomplete recovery. All the patients were treated with the widely-recognized treatment protocol. Results Fifty-six patients (59%) had complete recovery, 3 months after DCS seizure, and 39 patients (41%) had incomplete recovery following 3 months of treatment. Complete recovery rate in the young patients was higher than that in the old ones. The complete recovery rate of the patients with normal spinal cord MRI detection results was higher than that of the patients with abnormal MRI detection results, and the complete recovery rate of the patients with normal electrophysiological detection results was higher than that of the patients with abnormal electrophysiological detection results. The complete recovery rate of the patients with Boussuges scores ≤7 at onset time was higher than that of the patients with Boussuges scores of over 7. The complete recovery rate of the patients without back pain was higher than that of the patients with acute back pain. The complete recovery rate of the patients with over 50-minute symptom latency upon surfacing was higher than that of the patients with less than 50-minute symptom latency. The complete recovery rate of the patients with less than 4.5-hour time interval between symptom onset and HBO therapy was higher than that of the patients with over 4.5-hour time interval. Conclusions The patients with younger age, normal MRI detection results, normal electrophysiological data, Boussuges scores ≤7, no complaint of back pain after surfacing, longer symptom latency upon dive completion, and shorter time interval between symptom onset and HBO therapy would have better treatment outcomes. Key words: Spinal cord decompression sickness; Hyperbaric oxygen; Treatment outcome