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Surgical outcome and risk factors for cervical spinal cord injury patients in chronic stage: a 2-year follow-up study

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Abstract

Purpose

This study aims to assess the nerve function deficient recovery in surgically treated patients with cervical trauma with spinal cord injury (SCI) in chronic stage and figure out prognostic predictors of improvement in impairment and function.

Methods

We reviewed the clinical and radiological data of 143 cervical SCI patients in chronic stage and divided into non-operative group (n = 61) and operative group (n = 82). The severity of neurological involvement was assessed using the ASIA motor score (AMS) and Functional Independence Measure Motor Score (FIM MS). The health-related quality of life was measured using the SF-36 questionnaire. Correspondence between the clinical and radiological findings and the neurological outcome was investigated.

Results

At 2-year follow-up, surgery resulted in greater improvement in AMS and FIM MS than non-operative group. Regression analysis revealed that lower initial AMS (P = 0.000), longer duration after injury (P = 0.022) and injury above C4 level (P = 0.022) were factors predictive of lower final AMS. Longer duration (P = 0.020) and injury above C4 level (P = 0.010) were associated with a lower FIM MS. SF-36 scores were significantly lower in higher age (P = 0.015), female patients (P = 0.009) and patients with longer duration (P = 0.001).

Conclusion

It is reasonable to consider surgical decompression in patients with cervical SCI in chronic stage and persistent spinal cord compression and/or gross cervical instability. Initial AMS, longer duration, injury above C4 level, higher age and female patients are the five major relevant factors of functional recovery.

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Author notes

  1. Chengyue Ji, Yuluo Rong and Hongyu Jia contributed equally to the manuscript and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, China

    Chengyue Ji, Hongyu Jia, Ning Yan, Tiesheng Hou, Yao Li & Shunzhi Yu

  2. Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, China

    Chengyue Ji, Yuluo Rong & Weihua Cai

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  1. Chengyue Ji
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  2. Yuluo Rong
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Correspondence to Weihua Cai or Shunzhi Yu.

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Ji, C., Rong, Y., Jia, H. et al. Surgical outcome and risk factors for cervical spinal cord injury patients in chronic stage: a 2-year follow-up study. Eur Spine J 30, 1495–1500 (2021). https://doi.org/10.1007/s00586-020-06703-1

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  • DOI: https://doi.org/10.1007/s00586-020-06703-1

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