title: Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the clinical relationship between cervical spinal canal stenosis (CSCS) and incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation, and to discuss the clinical management of traumatic CSCI.
  
  
  METHODS
  Forty-seven patients with traumatic CSCI without major fracture or dislocation (30 out of 47 subjects; 63.83 %, had an injury at the C3-4 segment) and 607 healthy volunteers were measured the sagittal cerebrospinal fluid (CSF) column diameter at five pedicle and five intervertebral disc levels using T2-weighted midsagittal magnetic resonance imaging. We defined the sagittal CSF column diameter of less than 8 mm as CSCS based on the previous paper. We evaluated the relative and absolute risks for the incidence of traumatic CSCI related with CSCS.
  
  
  RESULTS
  Using data from the Spinal Injury Network of Fukuoka, Japan, the relative risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 124.5:1. Moreover, the absolute risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 0.00017.
  
  
  CONCLUSIONS
  In our results, the relative risk for the incidence of traumatic CSCI with CSCS was 124.5 times higher than that for the incidence without CSCS. However, only 0.017 % of subjects with CSCS may be able to avoid developing traumatic CSCI if they undergo decompression surgery before trauma. Our results suggest that prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, 550-4 Igisu, Iizuka, 820-0053, Japan, tsuneaki@iris.ocn.ne.jp.
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Takao
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Morishita
authors.forename: Seiji
authors.initials: S
authors.lastname: Okada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Maeda
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Katoh
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ueta
authors.forename: Eiji
authors.initials: E
authors.lastname: Mori
authors.forename: Itaru
authors.initials: I
authors.lastname: Yugue
authors.forename: Osamu
authors.initials: O
authors.lastname: Kawano
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Shiba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology*; D003251:Constriction, Pathologic; D016208:Databases, Factual; D019299:Decompression, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D004204:Joint Dislocations; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D013115:Spinal Canal / Q000293:injuries / Q000473:pathology; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures; D013130:Spinal Stenosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery