Trauma-induced spinal cord injury in cervical spondylotic myelopathy with or without lower cervical instability

Chen, Deyu; Wang, Xinwei; Chen, Yu; Miao, Jinhao; Liao, Xinyuan; Liu, Xiaowei

doi:10.1016/j.jocn.2012.02.051

Cited by 22 publications

(12 citation statements)

References 20 publications

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“…In the US state of Alabama, 31.5% of SCIs were caused by traffic accidents, 25.3% resulted from high falls and 10.4% resulted from gunshot wounds. 7 We found that high falls were the most common cause in our study, followed by traffic accidents, disease and low falls.…”

Section: Discussionsupporting

confidence: 50%

Several time indicators and Barthel index relationships at different spinal cord injury levels

Zhang

Chen

et al. 2015

Spinal Cord

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Study Design: Retrospective chart review. Objectives: To compare different injury levels in spinal cord injury (SCI) patients with respect to operation intervention time (OIT), rehabilitation intervention time (RIT), average length of hospital stay (ALOS) and Barthel Index (BI) on admission and discharge. Setting: China. Methods: We retrospectively analyzed data from 95 SCI cases who received treatment in our rehabilitation center from 2010-2013. Results: SCI resulted from high falls (55.79%), traffic accidents (28.42%), diseases (8.42%) and low falls (7.37%). We found no correlations between OIT, RIT, ALOS and discharge BI for all spinal segments (P40.05). The OIT of thoracic SCI and lumbar SCI correlated negatively with RIT (Po0.01). The OIT of lumbar SCI correlated negatively with ALOS (Po0.05). Conclusion: BI had no correlation with OIT, RIT or ALOS for all spinal segments; the OIT of thoracic and lumbar SCI correlated negatively with RIT; and the OIT of lumbar SCI correlated negatively with ALOS.

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Section: Discussionsupporting

confidence: 50%

Several time indicators and Barthel index relationships at different spinal cord injury levels

Zhang

Chen

et al. 2015

Spinal Cord

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“…According to their retrospective study of 72 patients with cervical stenosis who suffered low-energy trauma, patients with dynamic instability on X-ray were more likely to experience new or aggravated myelopathy posttrauma (81.3% vs 53.6%, P < .05). 18 Again this finding should be interpreted with caution because the authors did not report the subjects’ baseline neurological status pretrauma.…”

Section: Asymptomatic Cervical Spinal Cord Compressionmentioning

confidence: 90%

Clinico-Radiographic Discordance: An Evidence-Based Commentary on the Management of Degenerative Cervical Spinal Cord Compression in the Absence of Symptoms or With Only Mild Symptoms of Myelopathy

Witiw

Mathieu

Nouri

et al. 2017

Global Spine Journal

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Study Design:Narrative review with commentary.Objectives:The growing use of magnetic resonance imaging (MRI) often leaves clinicians faced with scenarios where imaging findings are inconsistent with the clinical picture. This is particularly relevant for degenerative cervical spinal cord compression (CSCC). In this article, we provide a focused narrative literature review to address whether (1) surgery should be offered to asymptomatic patients with CSCC and (2) should MRI spinal cord signal changes influence clinical decisions for a patient with mild myelopathy from CSCC?Methods:Illustrative cases are presented with expert commentary which is supplemented by a focused literature review.Results:The literature suggests that CSCC from degenerative pathology is a common incidental radiographic finding. For those without symptoms of myelopathy, the short-term risk of progression is low. There is a lack of evidence to support surgery for asymptomatic individuals with CSCC who have no risk factors for progression. For these patients, the authors suggest non-operative management that includes education on the symptoms of myelopathy, clinical follow-up within 6 to 12 months, and avoidance of high-risk activities. Conversely, symptomatic patients have a notable risk of progression. Surgical intervention improves neurological function and quality of life regardless of severity. The authors support surgery as an option for all patients with mild myelopathy who are appropriate operative candidates. Intramedullary signal change on MRI has not been shown to reliably predict progression.Conclusions:While MRI technologies are under evolution, we advise that surgical decisions for patients with CSCC should rely on clinical assessment and not imaging findings.

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“… 29 During trauma, osteophytes or disc protrusion or extrusion from the anterior, and ligamentum flavum from the posterior caused SCI. 30 …”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of poor clinical outcomes in patients with cervical kyphosis after cervical surgery for spinal cord injury

Zhang

et al. 2017

TCRM

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ObjectiveThis retrospective study investigated the incidence and risk factors of poor clinical outcomes after cervical surgery for cervical spinal cord injury in a large population of patients with global or segmental cervical kyphosis.MethodsThe clinical and radiological evaluation results of 269 patients with cervical kyphosis who underwent either anterior or posterior surgery between 2008 and 2013 were collected, preoperatively and at each follow-up after surgery.ResultsAll patients were followed for an average of 2.5 years. Outcomes were classified as good or poor (n=156 and 113 patients, respectively), based on the Japanese Orthopedic Association (JOA) recovery ratios. The rates of patients with good or poor outcomes were statistically comparable with regard to gender ratio, type of injury, history of diabetes or cardiovascular disease, interval between injury and surgery, and follow-up time. The multivariate logistic regression analysis indicated that the following were independent predictors of poor improvement: patient age (P=0.016, odds ratio [OR] =1.0261); preoperative JOA scores (P=0.003, OR =0.1932); and cervical instability (P=0.004, OR =2.1562).ConclusionThis study showed that advanced age, low preoperative JOA score, and cervical instability are closely associated with a poor surgical outcome in patients with cervical kyphosis. However, these results do not suggest that the type of cervical kyphosis influences the clinical outcome of surgery.

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Trauma-induced spinal cord injury in cervical spondylotic myelopathy with or without lower cervical instability

Cited by 22 publications

References 20 publications

Several time indicators and Barthel index relationships at different spinal cord injury levels

Several time indicators and Barthel index relationships at different spinal cord injury levels

Clinico-Radiographic Discordance: An Evidence-Based Commentary on the Management of Degenerative Cervical Spinal Cord Compression in the Absence of Symptoms or With Only Mild Symptoms of Myelopathy

Incidence and risk factors of poor clinical outcomes in patients with cervical kyphosis after cervical surgery for spinal cord injury

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