Spinal cord injury in cervical spinal stenosis by minor trauma.
BACKGROUND
The size of the spinal canal is a factor that contributes to the neurologic deficits associated with cervical OPLL and CSM. We investigate the development of neurologic deterioration after minor trauma and the clinical results of decompressive surgery in cervical spinal stenosis retrospectively.


METHODS
We treated 200 cases (98 cervical OPLLs and 102 CSMs) of cervical spinal stenosis for 8 years. There were 63 (33.5%) minor trauma cases to the cervical spine in 200 patients. Of these 63 patients, 18 developed myelopathy, 13 showed deterioration of preexisting myelopathy, and no neurologic change was observed in 32 patients. The neurologic status was assessed by the JOA score. The patients were divided into 2 groups according to the residual cervical spinal canal diameter: group I (<10 mm cervical spinal canal) and group II (> or =10 mm cervical spinal canal).


RESULTS
Neurologic outcome depended on the diameter of the residual spinal canal; 22 of the 25 patients in group I developed neurologic deterioration, whereas that occurred in 8 of the 38 patients in group II (P < .05). After surgical decompression, 8 patients in group I and 30 patients in group II came out with an improved JOA score of more than 50% (P < .05).


CONCLUSIONS
Even indirect minor trauma to the neck can cause irreversible changes in the spinal cord if there is marked stenosis of the cervical spinal canal. It may be beneficial to check lateral radiograph of the cervical spine as a screening tool for early detection of cervical spinal stenosis especially in Asian people older than 40 years.
Yoo
Do-Sung
DS
Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijongbu, South Korea.
Lee
Sang-Bok
SB
Huh
Pil-Woo
PW
Kang
Seok-Gu
SG
Cho
Kyoung-Suok
KS
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D015331:Cohort Studies; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome