Motor recovery of patients presenting with motor paralysis and sensory sparing following cervical spinal cord injuries.
We studied the neurological progress of 21 consecutive patients with cervical spinal cord injuries, presenting with sensory sparing but with complete motor paralysis below the level of their injury (Frankel B). All patients were admitted within 48 h of injury and treated conservatively with 6 weeks of bedrest and traction, followed by 6 weeks of bracing. The follow-up period was more than 1 year (49.6 months on average). Despite the initial absence of motor power in the lower limbs, seven patients recovered significant motor power and were able to walk. The preservation of pinprick sensation between the level of the injury and the sacral dermatomes was the best prognostic indicator for useful motor recovery with 75% of the patients regaining the ability to walk. This pattern of sensory sparing predicted a statistically significant better motor outcome than other patterns of sensory sparing. Although 50% of patients with no sacral sensation and/or with anal sensation on rectal examination recovered motor power, this recovery was functional in only one out of eight patients.
Midlands Centre for Spinal Injuries, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire, UK.
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el Masry
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology*; D009068:Movement; D009475:Neurons, Afferent / Q000502:physiology*; D010243:Paralysis / Q000503:physiopathology*; D011782:Quadriplegia / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000503:physiopathology*