Cervical fractures and spinal cord injury: outcome of surgical and nonsurgical management.
Data were collected retrospectively for 102 consecutive patients with a cervical spinal cord injury admitted to a spinal cord injury center between 1976 and 1986. Frankel's classification and level of spinal cord injury stayed the same or improved in all patients. The complications that occurred compared favorably with outcomes reported in the literature. Approximately 60% of patients achieved a catheter-free voiding status before dismissal from primary rehabilitation. Patients treated with early surgical stabilization of the cervical column were hospitalized a mean of 21 fewer days than their nonsurgical counterparts. In addition, patients treated with early surgical stabilization achieved their first therapeutic leave of absence from primary rehabilitation approximately 40 days sooner than patients stabilized nonsurgically. At final follow-up, however, no appreciable differences in achievement in activities of daily living and mobility were noted between patients treated with surgical stabilization of the cervical spinal column and those treated nonsurgically.
Murphy
K P
KP
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905.
Opitz
J L
JL
Cabanela
M E
ME
Ebersold
M J
MJ
D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000145:classification / Q000150:complications* / Q000601:surgery / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D008022:Ligaments / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000145:classification / Q000209:etiology* / Q000534:rehabilitation / Q000601:surgery; D013123:Spinal Fusion; D013997:Time Factors; D014546:Urinary Catheterization