Clinical Analysis Of Factors That Affect The Prognosis Of Cervical Spinal Cord Injury Without Fracture And Dislocation

Objective: To compare the difference of the prognosis of cervical spinal cord injury without fracture and dislocation(CSCIWFD)between the group of surgical treatment and the group of conservative treatment,and to analysis factors that interfere the prognosis of CSCIWFD.Methods: Forty-six cases with CSCIWFD were retrospectively analyzed and divided into operative treatment group and nonoperative treatment group,the average fellow-up time is 13.17 months.American spinal injury association(ASIA)impairment scale in admission and in follow-up were recorded to make comparison between operative treatment group and nonoperative treatment group.And all were divided into two groups according to the fact whether ASIA impairment scale improved at least 1 scale,ASIA impairment scale in admission was studied to find out connection between ASIA impairment scale improvement and the level of ASIA impairment scale itself in admission.Qualitative parameters including sex,disk herniation,signal changes within spinal cord were analyzed to demonstrate differences between these two groups.Quantitative parameters including age,MCC,MSCC,and length of lesion were analyzed to compare between two groups as well.Results: 1.The ASIA impairment scale improved ratio in operative group and nonoperative group were 35.00% and 46.15%,respectively.There was no significant difference between two groups statistically(P>0.05).2.ASIA impairment scale in admission has not shown statistical difference between groups with ASIA impairment scale escalating at least 1 point or not(P>0.05).3.Of the two groups in ASIA impairment scale improve at least 1 point or not,it turned out that differences were proved in qualitative parameters like signal changes within spinal cord(P<0.05),but not in sex and disc herniation(P >0.05).4.Apart from age factor(P >0.05),all other quantitative parameters like MCC,MSCC,and length of lesion in spinal cord have shown association with improvement in ASIA impairment scale(P <0.05).Conclusion: For CSCIWFD,the difference of prognosis is not relied on operative or nonoperative treatment which we choose,however,it has to do with factors like whetherchanges in spinal cord signal exist,the degree of MCC and MSCC,and length of lesion.The scale of neurologic impairment at admission was not associated with recovery.