The prognosis of acute blunt cervical spinal cord injury.
BACKGROUND
Cervical spinal cord injury (SCI) is a devastating event for the patient and family. It has a huge impact on society because of the intensive resources required to manage the patient in both the acute and rehabilitation phases. There is a need for better delineation of potential prognostic factors and outcomes in patients with acute cervical SCI.


METHODS
In this 5-year retrospective study, 75 adult patients diagnosed with acute nonfracture and nondislocation cervical SCI were enrolled into this study. Cervical X-ray and magnetic resonance imaging were available for all patients at admission and discharge. Epidemiologic data, management, complications, neurologic status, and change were assessed. Neurologic recovery from acute cervical SCI was determined by changes in the Japanese Orthopaedic Association score.


RESULTS
Thirty-eight patients had surgical intervention, accounting for 50.67% (38 of 75) of the episodes. The Japanese Orthopaedic Association outcome score between the two groups, with or without surgical intervention, was statistically significant (p = 0.035). Statistical analysis of the clinical manifestations and neurologic images of the two patient groups revealed the following significant findings: limb weakness (p = 0.025) and days of hospitalization (p = 0.039).


CONCLUSIONS
The treatment of acute nonfracture and nondislocation cervical SCI is still controversial and presents therapeutic challenges. A careful neurologic examination and high-resolution magnetic resonance imaging evaluation are necessary to determine whether surgical intervention is indicated. According to our data, when patients present with acute limb weakness, surgical intervention is necessary to improve the outcome.
Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Yu-Hua
YH
Huang
Tzu-Ming
TM
Yang
Wei-Che
WC
Lin
Jih-Tsun
JT
Ho
Tao-Chen
TC
Lee
Wu-Fu
WF
Chen
Cheng-Shyuan
CS
Rau
Hung-Chen
HC
Wang
D000208:Acute Disease; D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D026741:Physical Therapy Modalities; D011336:Probability; D011379:Prognosis; D020127:Recovery of Function; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications; D055815:Young Adult