In those cases where no improvement follows the recovery from the shock, and yet the suspicion remains that a complete crush of the cord has not occurred, we should operate immediately. This divides the cases, therefore, as follows: 1. Those that evidently have complete destruction of the cord; they should not be operated on. 2. Those where, following the recovery from the shock, it is evident that the lesion of the cord has not been completely destructive and yet no improvement is noted. Operation here should be done as soon as these facts are determined. 3. Those where the lesion of the cord is incomplete and where the symptoms of compression are extending as evidenced by increasing paralysis and the enlarged area of anesthesia. Here operation should be undertaken immediately, as there is a hemorrhage, an inflammatory thickening, or some acute process present that threatens the destruction of
LLOYD S. THE PRESENT STATUS OF SPINAL SURGERY. JAMA. 1901;XXXVI(18):1247–1253. doi:10.1001/jama.1901.52470180029001j
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