title: The pincers effect on cervical spinal cord in the development of traumatic cervical spinal cord injury without major fracture or dislocation.
abstract: METHODS
  Retrospective radiographic study.
  
  
  OBJECTIVE
  To investigate the pincers effect on cervical spinal cord in the development of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation.
  
  
  METHODS
  The Japan LHWO Spinal Injuries Center.
  
  
  METHODS
  Two hundred and twenty cases of traumatic CSCI without major fracture or dislocation were examined. The pinched diameters of the cervical spinal cord for 70 patients who complained of neck pain without neurological deficits were measured using sagittal-plane neutral and extension radiographs at 5 segments. These 70 patients were divided into 2 groups: group A patients were less than 40 years old and group B patients were 41 or more. We defined the pinched ratio of the cervical spinal cord during extension as ((sagittal diameter in the neutral image)-(sagittal diameter in the extension image))/(sagittal diameter in the neutral image)*100.
  
  
  RESULTS
  The incidence of traumatic CSCI without major fracture or dislocation at the C3-4, C4-5, C5-6 and C6-7 was 59.5, 25, 11.4 and 4.1%, respectively. Further, the pinched ratio of the cervical spinal cord at the C3-4 segment was significantly higher than that at the other segments.
  
  
  CONCLUSIONS
  We concluded that the cervical spinal cord at the C3-4 segment might receive the highest bony impingement load during acute hyperextension of the cervical spine. The extreme pincers load on the cervical spinal cord at the C3-4 segment may have one of the important roles in the development of traumatic CSCI at the C3-4 segment.
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan. uchiro1968@mac.com
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
authors.forename: T
authors.initials: T
authors.lastname: Maeda
authors.forename: M
authors.initials: M
authors.lastname: Naito
authors.forename: T
authors.initials: T
authors.lastname: Ueta
authors.forename: K
authors.initials: K
authors.lastname: Shiba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D055815:Young Adult