A review of cervical spine injuries with neurological dysfunction

Bedbrook, George M.; Sakae, Terumi

doi:10.1038/sc.1982.62

Cited by 36 publications

(26 citation statements)

References 6 publications

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“…This difference by Kurtzke (1975) was explained to reflect the complete rehabilitaion in the former, and the acute short term care in the latter study, but it is also worth mentioning that the classifications were differ ent. Otherwise our results confirm these two studies, and those from Australia (Bedbrook and Sakae, 1982;Burke and Murray, 1976) in that incomplete lesions are more likely to improve than complete, regardless of level. In addition our material confirms the findings of Frankel et al (1969) regarding the better chance for neurological improvement in complete cervical compared with com plete thoracic/lumbar lesions.…”

Section: Discussionsupporting

confidence: 90%

Epidemiology of spinal cord lesions in Denmark

Biering-Sørensen

Pedersen²,

Clausen³

1990

Spinal Cord

112

100

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SununaryDenmark has a population of about 5·2 million. The rehabilitation of spinal cord injured (SCI) takes place in two specialised rehabilitation hospitals. The incidence of new traumatic SCI admitted to these hospitals in the period 1975-1984 was 9· 2 per million per year. During this period 92 Danes with non-traumatic and 268 with newly sustained traumatic spinal cord lesions were admitted to the rehabilitation hospital in Hornbeek, which uptake area corresponded to South and East Denmark and Greenland and the Faroe Islands. Among the traumatic SCI 47% were due to traffic accidents, 23% to falls to a level below, 8% to attempted suicides, 6% to shallow water diving, and 6% to sporting accidents. The number of SCI caused by traffic accidents was found to decrease coincidently with the introduction of general speed limits and compulsory seat belt wearing. The male/female ratio was for the traumatic SCI 3-3, which was significantly lower than in the preceding la-year period. 40% of all traumatic SCI were sustained at 15-24 years of age, and 51% had tetraplegia. Traffic accidents gave rise to more cervical, and falls to more caudal lesions. 41 % of the traumatic SCI had an improvement in their neuro logical status after their admission to the neurosurgical department until the dis charge from the rehabilitation hospital. Those with incomplete lesions showed greater improvement than those with complete lesions regardless of the level. Complete cervical lesions had significant better remissions than complete thoracic/lumbar lesions.

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Section: Discussionsupporting

confidence: 90%

Epidemiology of spinal cord lesions in Denmark

Biering-Sørensen

Pedersen²,

Clausen³

1990

Spinal Cord

112

100

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“…In Jordan drinking and driving is not a common occurrence because of adherence to religious beliefs, unlike other reported studies incriminating drinking and driving as a major cause in tra c accidents 16 .…”

Section: Discussionmentioning

confidence: 87%

Traumatic spinal cord injuries in Jordan – an epidemiological study

et al. 1997

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To survey the situation of traumatic spinal cord injuries (SCI) in Jordan and for a future nationwide epidemiological survey, a retrospective study was conducted at the Royal Jordanian Rehabilitation Centre (RJRC) King Hussein Medical Centre (KHMC) AmmanJordan, where all traumatic cases within this centre in addition to a few nontraumatic spinal injury patients are referred to the spinal unit which has a capacity of 30 beds. 151 traumatic SCI patients who were admitted to the spinal unit at RJRC during the period January 1988 to December 1993 were reviewed. The estimated annual incidence was 18 per million population. The majority were predominantly males (85.4%) the male/female ratio was 5.8:1. The mean age at the time of injury was 33 being 30.9 years for males and 34.8 years for females. There were 68% (n=103) with paraplegia and 32% (n=48) with tetraplegia (Frankel A ± D). The commonest aetiology was motor vehicle accidents (44.4% n=67), next came bullet injuries (25.8% n=39), followed by accidental falls (21.2% n=32). Other causes of SCI, and also the importance of preventive measures are discussed.

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“…The only prospective randomized trial to determine whether functional outcome is improved in traumatic cervical spinal cord injured patients is Vaccaro et al 17 The results of this study revealed no significant benefit if decompression and fixation is performed less than 72 h after injury (mean 1.8 days), as opposed to waiting longer than 5 days (mean 16.8 days). 8 We found that Frankel grading in combination with ASIA motor scoring is a powerful tool for measuring neurological outcome. Both conservative and surgical management modalities should be discussed with patients before obtaining informed consent.…”

Section: Discussionmentioning

confidence: 91%

“…5,6 Various investigators have also reported spontaneous neurological recovery in the conservatively managed group. [7][8][9] Neurological deterioration following spinal surgery was observed in the past. This was because decompressive laminectomy was being performed without any stabilization of the cervical spine.…”

Section: Introductionmentioning

confidence: 99%

Neurological outcome in surgically treated patients with incomplete closed traumatic cervical spinal cord injury

et al. 2008

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Study design: Retrospective study based on a reference paper. Neurological outcome in patients who were managed surgically with closed traumatic cervical spine injury was evaluated using the ASIA motor scoring system and Frankel grading. Objectives: To assess the accuracy of motor charting and Frankel grading as tools to evaluate neurological outcome in closed traumatic cervical spine injury, and also to evaluate how the surgically treated patients fared in their neurological recovery by measurement tools as in the reference paper. Setting: National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. Method: Fifty-seven patients were admitted within 2 days of the injury with closed traumatic cervical spine injuries (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004). Thirty-seven (65%) met the inclusion criteria as per the referenced paper, that is, were treated surgically, were Frankel grade B and above and had at least 12 months follow up. The remaining 20 patients were not included as they did not meet the inclusion criteria. The breakdown of the 20 patients is given in Table 1. The mean recovery percentage (MRP) and mean deficit percentage (MDP) were calculated as per the referenced paper. Results: An evaluation of 37 patients surgically treated, who had follow up of at least 12 months, showed that preservation of pin prick below the level of lesion, and preservation of anal tone and perianal sensation were good prognostic indicators. There was no correlation between degree of encroachment of canal or the degree of kyphosis to MDP or MRP. The mean time from injury to mobilization was 7.6 days in 25 out of 37 patients. Twelve of the 37 patients had prolonged immobilization because of ITU stay or because they were initially treated conservatively. Three out of the 37 patients developed DVT/PE. Mean hospital stay was 6.4 months. Conclusion: The neurological outcome in surgically treated patients is comparable to the conservatively treated patients. The Frankel grading and ASIA motor charting combined is a powerful tool in assessing the neurological outcome in closed traumatic cervical spinal injured patients. Until now there has been no evidence to suggest that the obvious advantages of surgical management of closed cervical spine injuries (better alignment, easier manual handling and early mobilization) is traded for poorer neurological outcome.

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A review of cervical spine injuries with neurological dysfunction

Cited by 36 publications

References 6 publications

Epidemiology of spinal cord lesions in Denmark

Epidemiology of spinal cord lesions in Denmark

Traumatic spinal cord injuries in Jordan – an epidemiological study

Neurological outcome in surgically treated patients with incomplete closed traumatic cervical spinal cord injury

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