The Efficacy of Non-operative and Operative Intervention in Regards to Motor Recovery in the Setting of Cervical Spinal Cord Injury

• Main Authors: Alexander R Vaccaro, Vafa Rahimi-Movaghar, Mehdi Mohammadi
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2009-12-01
• Series: Iranian Journal of Psychiatry
• Subjects: Cervical; Decompression; Spinal cord injury; Surgery
• Online Access: https://ijps.tums.ac.ir/index.php/ijps/article/view/515
• ISSN: 1735-4587; 2008-2215

Objective: An assessment of  nonoperative and operative intervention in regards  to  neurological  improvement  following  traumatic  closed  cervical spinal cord injury (CSCI). Method: A retrospective evaluation of a cohort of patients with a CSCI from C3 to T1 was reviewed. The analysis included a total of 13 eligible patients. The  neurologic  and  functional outcomes  were  recorded  from  the  acute hospital admission to the most recent follow-up. Data included patients' age; level of injury, neurologic exam according to the Frankel grading system, the performance of surgery, the mechanism and timing of the CSCI decompression, and motor index score (MIS). Results: Ninety-two percent of the patients were male with the mean age of 28.2 ± 11.5. Before treatment, 10/13 patients (77.0%) had functionally complete neurological deficits below the level of injury. The median interval from injury to surgery was 16 days. Eight patients underwent surgical intervention and  five  were  treated  nonoperatively. The  median  length  of follow-up was 14 months after surgery (Range: 7 - 93 months). Spinal cord functional improvement was observed in 2/8 (25%) of the surgically managed patients  and  in  4/5  (80%)  of  the patients  treated  nonoperatively.  Root recovery  was  observed  in  6/8  (75%)  of  the  patients  who  were  treated surgically and 4/5 (80%) of the patients treated nonoperatively. Conclusion: Some degree of motor score improvement occurs following a closed cervical spinal cord injury with or without operative surgery in the follow up period.