Significance of spinal cord swelling in the prognosis of acute cervical spinal cord injury.

Seven cases of acute cervical cord injury examined by CT-myelography are reported. Cord swelling was observed in 2 patients who developed complete lesions. Another 5 cases had an incomplete lesions. Spinal cord swelling indicated severe cord damage. External decompression seemed to have little effect on cord swelling. When cord swelling is absent, neurological improvement was expected though the initial neurological state showed severe deficits. A further 4 patients who had an acute cervical cord injury who were treated by myelotomy at the injury site are also reported. Two patients obtained significant improvement in upper limb function. The presence or absence of cord swelling as shown by CT-myelography is important for diagnosing the severity of cord damage. Myelotomy in the immediate post-accident period may relieve the effects of cord swelling.