Early surgical treatment of cervical spinal cord injury without radiographic abnormalities in adults

doi:10.3877/cma.j.issn.2095-9141.2021.01.010

Abstract

Abstract:

Objective

To evaluate the effect of early surgical treatment for cervical spinal cord injury without radiographic abnormalities (CSCIWORA) in adults.

Methods

Thirty-seven adult CSCIWORA patients treated in Neurosurgery Department of 920^th Hospital of Joint Logistics Support Force from May 2014 to October 2018 were retrospectively analyzed. According to the treatment methods, they were divided into operation group (25 cases) and conservative group (12 cases). The operation group was treated with laminectomy and internal fixation, and the conservative group was treated with conservative treatment. According to the American Spinal Cord Injury Association (ASIA) standard, the spinal cord function of the two groups was scored. The patients were followed up for 6, 12 and 24 months to evaluate the recovery of spinal cord function.

Results

There were no serious complications in the 25 patients. After 6, 12 and 24 months of intervention, the ASIA motor score of the operation group was higher than that of the conservative group, and the difference was statistically significant (P<0.05). The ASIA motor score recovered faster in half a year, and slowed down significantly after half a year.

Conclusion

Early decompression and fixation can promote the early recovery of cervical spinal cord function and improve the long-term effect.

Key words: Cervical spinal cord injury without radiographic abnormalities, American Spinal Cord Injury Association motor score, American Spinal Cord Injury Association impairment scale, Adults

Ning Cao, Shemin Zhang, Fang Fang, Jiaxin Xie, Yu Feng, Xunding Deng, Yaping Feng. Early surgical treatment of cervical spinal cord injury without radiographic abnormalities in adults[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(01): 42-45.

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References 16

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组别	时间	B级	C级	D级	E级
手术组(n=25)	治疗前	1(4)	16(64)	8(32)	0
	治疗后6个月	0	6(24)	8(32)	11(44)
	治疗后12个月	0	3(12)	5(20)	17(68)
	治疗后24个月	0	1(4)	6(24)	18(72)
保守组(n=12)	治疗前	0	7(58.3)	5(41.7)	0
	治疗后6个月	0	6(50.0)	5(41.7)	1(8.3)
	治疗后12个月	0	4(33.3)	7(58.3)	1(8.3)
	治疗后24个月	0	3(25.0)	8(66.7)	1(8.3)

组别	时间	B级	C级	D级	E级
手术组(n=25)	治疗前	1(4)	16(64)	8(32)	0
	治疗后6个月	0	6(24)	8(32)	11(44)
	治疗后12个月	0	3(12)	5(20)	17(68)
	治疗后24个月	0	1(4)	6(24)	18(72)
保守组(n=12)	治疗前	0	7(58.3)	5(41.7)	0
	治疗后6个月	0	6(50.0)	5(41.7)	1(8.3)
	治疗后12个月	0	4(33.3)	7(58.3)	1(8.3)
	治疗后24个月	0	3(25.0)	8(66.7)	1(8.3)

组别	例数	治疗前	治疗后6个月	治疗后12个月	治疗后24个月	F值	P值
手术组	25	42.56±17.96	83.04±21.62^a	90.84±16.06^a	93.68±12.17^ab	42.223	<0.001
保守组	12	43.63±11.54	64.72±23.37^a	67.27±22.35^a	68.36±20.93^a	3.527	0.024
t值		-0.178	2.274	3.475	3.580
P值		0.860	0.029	0.001	0.003

组别	例数	治疗前	治疗后6个月	治疗后12个月	治疗后24个月	F值	P值
手术组	25	42.56±17.96	83.04±21.62^a	90.84±16.06^a	93.68±12.17^ab	42.223	<0.001
保守组	12	43.63±11.54	64.72±23.37^a	67.27±22.35^a	68.36±20.93^a	3.527	0.024
t值		-0.178	2.274	3.475	3.580
P值		0.860	0.029	0.001	0.003

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