Neurological recovery after conservative treatment of cervical cord injuries.

We reviewed a series of 53 patients with closed traumatic complete injuries of the cervical spinal cord. They were admitted within two days to a spinal injuries centre, treated conservatively by six weeks of bedrest and skull traction, then mobilised in a neck support for six weeks. Eight patients had temporary neurological deterioration, four spontaneously and four after cervical manipulation; seven of these recovered to the initial neurological level without surgery. Of 40 patients followed for more than 12 months, 19 recovered useful motor power in local muscles which were initially paralysed (zonal recovery); one patient showed distal motor recovery. Zonal recovery did not correlate with the mechanism of skeletal injury or with the degree of residual canal stenosis. Sensory sparing and an initial neurological level higher than the level of skeletal injury were both good prognostic signs for zonal recovery.

[1]  D O Hancock,et al.  The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia , 1969, Paraplegia.

[2]  H. Frankel.  Ascending cord lesion in the early stages following spinal injury , 1969, Paraplegia.

[3]  F Holdsworth,et al.  Fractures, dislocations, and fracture-dislocations of the spine. , 1963, The Journal of bone and joint surgery. American volume.

[4]  G. Wharton,et al.  The results of laminectomy in patients with incomplete spinal cord injuries , 1971, Paraplegia.

[5]  E. Stauffer.  Diagnosis and prognosis of acute cervical spinal cord injury. , 1975, Clinical orthopaedics and related research.

[6]  Stauffer Es.  Diagnosis and prognosis of acute cervical spinal cord injury. , 1975 .

[7]  E. Stauffer,et al.  Fracture-dislocations of the cervical spine. Instability and recurrent deformity following treatment by anterior interbody fusion. , 1977, The Journal of bone and joint surgery. American volume.

[8]  G. Bedbrook.  Spinal injuries with tetraplegia and paraplegia. , 1979, The Journal of bone and joint surgery. British volume.

[9]  P. Harris,et al.  The prognosis of patients sustaining severe cervical spine injury (C2-C7 inclusive) , 1980, Paraplegia.

[10]  B. Allen,et al.  A Mechanistic Classification of Closed, Indirect Fractures and Dislocations of the Lower Cervical Spine , 1982, Spine.

[11]  Stauffer Es.  Neurologic recovery following injuries to the cervical spinal cord and nerve roots. , 1984 .

[12]  E. Stauffer.  Neurologic Recovery Following Injuries to the Cervical Spinal Cord and Nerve Roots , 1984, Spine.

[13]  E. Benzel,et al.  Recovery of nerve root function after complete quadriplegia from cervical spine fractures. , 1986, Neurosurgery.

[14]  C H Tator,et al.  Comparison of Surgical and Conservative Management in 208 Patients with Acute Spinal Cord Injury , 1987, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[15]  E. Spatz,et al.  Acute Ascending Myelopathy of the Spine , 1989, Spine.

[16]  R. Waters,et al.  Definition of complete spinal cord injury , 1991, Paraplegia.

[17]  E. Spatz,et al.  Nerve Root Recovery in Complete Injuries of the Cervical Spine , 1991, Spine.

[18]  P. Anderson,et al.  Anterior decompression and arthrodesis of the cervical spine: long-term motor improvement. Part I--Improvement in incomplete traumatic quadriparesis. , 1992, The Journal of bone and joint surgery. American volume.

[19]  W. Donovan,et al.  Neurological and skeletal outcomes in 113 patients with closed injuries to the cervical spinal cord , 1992, Paraplegia.

[20]  S L Stover,et al.  Motor recovery of the upper extremities in traumatic quadriplegia: a multicenter study. , 1992, Archives of physical medicine and rehabilitation.