Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tewari MK, Gifti DS, Singh P, Khosla VK, Mathuriya SN, Gupta SN et al (2005) Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients. Surg Neurol 63:204–209

    Article  PubMed  Google Scholar 

  2. Gupta SK, Rajeev K, Khosla VK, Sharma BS, Paramjit SN, Pathak A et al (1999) Spinal cord injury without radiographic abnormality in adults. Spinal Cord 37:726–729

    Article  PubMed  CAS  Google Scholar 

  3. Kothari P, Freeman B, Grevitt M, Kerslake R (2000) Injury to the spinal cord without radiological abnormality (SCIWORA) in adults. J Bone Joint Surg Br 82:1034–1037

    Article  PubMed  CAS  Google Scholar 

  4. Wenger M, Adam PJ, Alarcon F, Markwalder TM (2003) Traumatic cervical instability associated with cord oedema and temporary quadriparesis. Spinal Cord 41:521–526

    Article  PubMed  CAS  Google Scholar 

  5. Koyanagi I, Iwasaki Y, Hida K, Akino M, Imamura H, Abe H et al (2000) Acute cervical cord injury without fracture or dislocation of the spinal column. J Neurosurgery 93:15–20

    CAS  Google Scholar 

  6. Tator CH (1995) Clinical manifestations of acute spinal cord injury. In: Benzel EC, Tator CH (eds) Contemporary management of spinal cord injury. Park Ridge, American Association of Neurological Surgeons, pp 15–26

    Google Scholar 

  7. Harrop JS, Sharan A, Ratliff J (2006) Central cord injury: pathophysiology, management, and outcomes. Spine J 6:198S–206S

    Article  PubMed  Google Scholar 

  8. Shimada K, Tokioka T (1995) Sequential MRI studies in patients with cervical cord injury but without bony injury. Paraplegia 33:573–578

    Article  PubMed  CAS  Google Scholar 

  9. Takahashi M, Harada Y, Inoue H, Shimada K (2002) Traumatic cervical cord injury at C3–4 without radiographic abnormalities: correlation of magnetic resonance findings with clinical feature and outcome. J Orthop Surg (Hong Kong) 10:129–135

    CAS  Google Scholar 

  10. Morishita Y, Naito M, Wang JC (2011) Cervical spinal canal stenosis: the differences between stenosis at the lower cervical and multiple segment levels. Int Orthop 35:1517–1522

    Article  PubMed  Google Scholar 

  11. Morishita Y, Naito M, Hymanson H, Miyazaki M, Wu G, Wang JC (2009) The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine. Eur Spine J 18:877–883

    Article  PubMed  Google Scholar 

  12. Okada Y, Ikata T, Yamada H, Sakamkto R, Katoh S (1993) Magnetic resonance imaging study on the results of surgery for cervical compression myelopathy. Spine 18:2024–2029

    Article  PubMed  CAS  Google Scholar 

  13. Herzog RJ, Weins JJ, Dillingham MF, Sontag MJ (1991) Normal cervical spine morphometry and cervical spine stenosis in asymptomatic professional football players. Spine 16:178–186

    Article  Google Scholar 

  14. Anderson PA, Steinmetz MP, Eck JC (2006) Head and neck injuries in athletes. In: Spivak JM, Connolly PJ (eds) Orthopaedic knowledge update: Spine 3. Rosemont, AAOS, pp 259–269

    Google Scholar 

  15. Sakai H, Ueta T, Shiba K (2010) Current situation of medical care for spinal cord injury in Japan (in Japanese). J Spine Res 1:41–51

    Google Scholar 

  16. Edward WC, LaRocca H (1983) The developmental segmental sagittal diameter of the cervical spinal canal in patients with cervical spondylosis. Spine 8:20–27

    Article  Google Scholar 

  17. Gore DR (2001) Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine 26:2463–2466

    Article  PubMed  CAS  Google Scholar 

  18. Yamazaki T, Yanaka K, Fujita K, Kamezaki T, Uemura K, Nose T (2005) Traumatic central cord syndrome: analysis of factors affecting the outcome. Surg Neurol 63:95–99

    Article  PubMed  Google Scholar 

  19. La Rosa G, Conti A, Cardali S, Cacciola F, Tomasello F (2004) Does early decompression improve neurological outcome of spinal cord injured patients? Appraisal of literature using a meta-analytical approach. Spinal Cord 42:503–512

    Article  PubMed  Google Scholar 

  20. Chen TY, Dickman CA, Eleraky M, Sonntag VKH (1998) The role of decompression for acute incomplete cervical spinal cord injury in cervical spondylosis. Spine 23:2398–2403

    Article  PubMed  CAS  Google Scholar 

  21. Bose B, Northrup BE, Osterholm JL, Cotler JM, DiTunno JF (1984) Reanalysis of central cervical cord injury management. Neurosurgery 15:367–372

    Article  PubMed  CAS  Google Scholar 

  22. Kawano O, Ueta T, Shiba K, Iwamoto Y (2010) Outcome of decompression surgery for cervical spinal cord injury without bone and disc injury in patients with spinal cord compression: a multicenter prospective study. Spinal Cord 48:548–553

    Article  PubMed  CAS  Google Scholar 

  23. Itoh Y, Mazaki T, Koshimune K, Morita T, Mizuno S (2011) Randomized controlled study of treatment for acute cervical cord injury with spinal canal stenosis but without radiographic evidence of trauma (SCIWORET): operative or conservative treatment. J Spine Res 2:965–967

    Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Spinal Injuries Center, 550-4 Igisu, Iizuka, 820-0053, Japan

    Tsuneaki Takao, Yuichiro Morishita, Takeshi Maeda, Takayoshi Ueta, Eiji Mori, Itaru Yugue, Osamu Kawano & Keiichiro Shiba

  2. Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan

    Seiji Okada

  3. Department of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya, Japan

    Fumihiko Katoh

Authors
  1. Tsuneaki Takao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuichiro Morishita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seiji Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fumihiko Katoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takayoshi Ueta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eiji Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Itaru Yugue
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Osamu Kawano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Keiichiro Shiba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tsuneaki Takao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Takao, T., Morishita, Y., Okada, S. et al. Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation. Eur Spine J 22, 2228–2231 (2013). https://doi.org/10.1007/s00586-013-2865-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2865-7

Keywords

Search

Navigation