Does cervical curvature affect neurological outcome after incomplete spinal cord injury without radiographic abnormality (SCIWORA): 1-year follow-up

Abstract

Background At present, surgery is the primary clinical treatment for SCIWORA patients, but conservative treatment still plays an important role in patients with incomplete spinal cord injury. As an important index of cervical spine degeneration, cervical curvature has an impact on the prognosis of spinal cord injury patients. This paper studied the prognosis of conservatively treated patients with SCIWORA and the correlation between cervical curvature and neurological prognosis. Methods A retrospective study was conducted in all the patients with SCI admitted to the Third Affiliated Hospital of Hebei Medical University between January 2017 and June 2020. Data were recorded in 106 eligible patients, including sex, age, injury factors, Cobb angle, CCI, CSA, and ASIA motor and sensory scores. The Wilcoxon sign rank sum test was used to analyze the data postinjury and at the 1-year follow-up. Pearson correlation analysis was performed for the Cobb angle, CCI and CSA. Simple linear regression analysis and multiple linear regression analysis were performed for each group of variables. Results The Wilcoxon signed rank sum test confirmed that the Cobb angle, the CCI and the CSA of the patients were not significantly different at the 1-year follow-up when compared with the postinjury values, and the ASIA motor and sensory scores were significantly improved. The Pearson correlation analysis showed correlations among the Cobb angle, the CCI and the CSA. Simple linear regression analysis and multiple linear regression analysis showed that the nerve recovery rate was negatively correlated with age and was positively correlated with the Cobb angle. Conclusion Conservative treatment of incomplete SCIWORA can achieve a good prognosis. There is a clear correlation between the Cobb angle, CCI and CSA, and the Cobb angle, as an important influencing factor, needs to be considered. For SCIWORA patients undergoing nonsurgical treatment, improving cervical curvature is beneficial to the prognosis of patients. Age negatively affects the neurological prognosis.

Management of Cervical Spinal Cord Injury without Major Bone Injury in Adults

“…A review of MRI measurements showed that cord-canal mismatch (a higher spinal cord occupation ratio in the spinal canal) was more important and should be viewed as the underlying mechanism predisposing individuals to SCI [17]. In addition, a report suggests that improving the cervical curvature can positively impact prognosis, as the cervical curvature in patients with total spinal balance can be affected by nonsurgical treatment for CSCI without major bone injury [18].…”

Cervical Alignment and Range of Motion Change after Anterior 3‐Level Hybrid Surgery Compared with Cervical Laminoplasty: A Matched Cohort Study

“…Scheer et al 1 reviewed the literature and found a correlation between the variation of radiographic parameters and postoperative health‐related quality of life. Plenty of studies demonstrate that it is vital to restore neutral cervical lordosis and preserve cervical ROM in cervical spine surgery 4–7 . However, for multilevel cervical spondylotic myelopathy (CSM) surgery treatment, cervical biomechanical and kinematics structures may be widely disturbed, bringing more challenges to maintaining cervical alignment and preserving ROM.…”