Clinical Analysis of Cervical Spinal Cord Injuries without Bony Lesion.

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The pathogenesis, prognosis and proper treatment of the cervical spinal cord injury have not yet been resolved. In order to make these problems clear, we analysed our 22 cases.These consisted of 20 males and 2 females with the average of 54.1 years old. The types of injury contained 1 case of complete cord lesion, 7 cases of anterior cord injury, 11 cases of central cord injury and 3 cases of Brown-Séquard syndrome. More than half of the cases suffered from hyperextension injury, and especially, most of the central cord injury cases suffered from it.As to the treatment, 17 cases were treated conservatively, while 5 cases underwent operative treatment. Anterior decompression and fusion by Cloward's method was performed in 2 cases of traumatic disc herniation, and laminectomy and/or laminoplasty was done in 3 cases of having OPLL.As for the prognosis, 1 case of complete cord lesion died. In the 21 cases of imcomplete cord lesion, two-step improvement on Frankel's classificarion was seen in 2 cases, both of which belonged to central cord injury, one-step improvement in 17 cases, and no improvement in 2 cases. There was no significant prognostic difference between conservative therapy and operative treatment.
西日本整形・災害外科学会の論文