The Functional And Neurological Outcome In Cervical Spine Injuries: A Retrospective Review

Abstract

BACKGROUND: Until recently, vertebral injuries were less commonly in cervical spine than Thoracic and lumbar region. With the decline in accidents from mining and other heavy industry and increase in Road traffic accidents, this incidences has change. At present out of significant spinal injury approx. 50% involves the cervical spine and approx. 40% of them lead to quadriplegia and approx. 10% of traumatic cord injuries have no obvious radiographic evidence of vertebral injury (SCIWORA). Aim of this retrospective case-series with 25 patients was to assess Neurological and functional outcome in Cervical Spine Injuries. RESULTS: There were 10 patients with lower cervical spine fractures (C3-C7),5 patients with upper cervical fractures,10 patients had SCIWORA injuries. Initial ASIA scale: A:4,B:3,C:5, D:8 & E:5. 15 patients were treated conservatively with cervical tongs and orthotics. Rest of 10 patients treated operatively with anterior cervical platting. Full neurological recovery in 10 patients and 40% of patients had poor neurological outcome , which is significantly higher. 5 patients (20%) were associated with glutei sores or cranial sores. 3 patients had chest infection due to respiratory pneumonitis, 3 patients had major depression (psychological complication).Operative patients were commonly associated with cardio respiratory compromise most probably due to ascending cord edema, in 24% patients. CONCLUSIONS: To conclude cervical spine injury is continuing to be fatal and paralyzing injury with poor and unpredictable neurological outcome. Final neurological outcome is depends on primary neurological damage. SCIWORA type of cervical spine injury and stable cervical spine fractures associated with good neurological outcome. Poor Neurological Outcome is associated with High velocity trauma and unstable, lower cervical spine bony injury. Functional Outcome mostly depends on final neurological outcome and can be improved with proper rehabilitation programme.