Correlation Between Low Cervical Stability And Prognosis In Patients With Cervical Spinal Cord Injury Without Fracture And Dislocation

Cervical spinal cord injury without fracture and dislocation(CSCIWFD)is a special type of cervical spinal cord injury,when the patients were subjected to horizontal violence in the craniofacial region,then the excessive flexion of the cervical spine caused acute spinal cord injury,it is a common traumatic disease.In the acute period after the injury,there were no obvious signs of fracture and dislocation through the examination of X-ray and CT.Researched the related factors of the prognosis in patients with CSCIWFD can not only adjust the treatment strategy,but also better guide the clinical management.There were many studies on the prognostic factors of CSCIWFD at home and abroad,but the correlation between low cervical stability and prognosis was not clear.Objective1.To investigate the correlation between the stability of low cervical spine and its prognosis in adult patients with CSCIWFD.2.To observe the short-term clinical effect of adult patients with CSCIWFD who were underwent anterior cervical surgery.MethodsThe data of 47 patients with CSCIWFD were retrospectively analyzed from January 2010 to December 2015 in our hospital.Patients were divided into stable low cervical vertebra group(SLCV)and non-stable low cervical vertebra group(NSLCV)according to the presence or absence of prevertebral high signal(PVH)on MRI T2 WI.There were 31 male patients and 16 female patients.The average age was 55.4 ± 8.5 years(34 to 73 years).All patients underwent anterior cervical surgery.VAS,JOA and NDI scale were used to evaluate the pain,neurological function and health-related quality of life.ResultThe postoperative VAS,JOA and NDI scores of all patients were significantly improved compared with that before operation,and the improvement of patients gradually increased within 1 year after operation.The preoperative VAS,JOA scores of two groups were significantly different(P <0.05),the preoperative NDI scores of two groups were no significant difference(P>0.05).There was no significant difference in VAS,JOA and JOA improvement rate between the two groups at the last follow-up(P> 0.05),but NDI was significant.The length of PVH and preoperative JOA score had a significant negative correlation(r =-0.693,P<0.01),the postoperative improvement rate of JOA also has obvious negative correlation(r =-0.571 P <0.01).ConclusionFor patients with low cervical instability at the same time as fully decompressed,the stability of the lower cervical spine should be reconstructed to obtain a better prognosis.The short-term clinical efficacy of patients with CSCIWFD who underwent anterior cervical surgery were splendid.