Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation

被引:54
作者
Takao, Tsuneaki [1 ]
Morishita, Yuichiro [1 ]
Okada, Seiji [2 ]
Maeda, Takeshi [1 ]
Katoh, Fumihiko [3 ]
Ueta, Takayoshi [1 ]
Mori, Eiji [1 ]
Yugue, Itaru [1 ]
Kawano, Osamu [1 ]
Shiba, Keiichiro [1 ]
机构
[1] Spinal Injuries Ctr, Dept Orthopaed Surg, Iizuka, Fukuoka 8200053, Japan
[2] Kyushu Univ, Dept Orthopaed Surg, Fukuoka 812, Japan
[3] Chubu Rosai Hosp, Dept Orthopaed Surg, Nagoya, Aichi, Japan
关键词
Cervical spinal canal stenosis; Traumatic cervical spinal cord injury without major fracture or dislocation; MRI; Relative risk; Absolute risk; Prophylactic surgical management; RADIOGRAPHIC ABNORMALITY; DECOMPRESSION; COMPRESSION; SPONDYLOSIS; DIAMETER; SURGERY; ADULTS;
D O I
10.1007/s00586-013-2865-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The purpose of the study was to evaluate the clinical relationship between cervical spinal canal stenosis (CSCS) and incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation, and to discuss the clinical management of traumatic CSCI. Forty-seven patients with traumatic CSCI without major fracture or dislocation (30 out of 47 subjects; 63.83 %, had an injury at the C3-4 segment) and 607 healthy volunteers were measured the sagittal cerebrospinal fluid (CSF) column diameter at five pedicle and five intervertebral disc levels using T2-weighted midsagittal magnetic resonance imaging. We defined the sagittal CSF column diameter of less than 8 mm as CSCS based on the previous paper. We evaluated the relative and absolute risks for the incidence of traumatic CSCI related with CSCS. Using data from the Spinal Injury Network of Fukuoka, Japan, the relative risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 124.5:1. Moreover, the absolute risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 0.00017. In our results, the relative risk for the incidence of traumatic CSCI with CSCS was 124.5 times higher than that for the incidence without CSCS. However, only 0.017 % of subjects with CSCS may be able to avoid developing traumatic CSCI if they undergo decompression surgery before trauma. Our results suggest that prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.
引用
收藏
页码:2228 / 2231
页数:4
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