Early outcome in cervical spinal cord injured patients older than 50 years of age.

STUDY DESIGN

This study retrospectively reviewed consecutive spinal cord injured patients older than 50 years of age.

OBJECTIVE

This study established reasonable expectations for the early clinical outcome of cervical spinal cord injured patients greater than 50 years of age.

SUMMARY OF BACKGROUND DATA

Previous studies of cervical spinal cord injuries have concentrated on long-term morbidity and mortality. Little data has been reported on the early clinical outcome during rehabilitation.

METHODS

Forty-two consecutive patients older than 50 years of age at the time of cervical cord injury were reviewed. Data was collected from the time of injury to discharge from rehabilitation (< 4 months) and included morbidity, mortality, and disposition of the patient.

RESULTS

There were 15 complete and 27 incomplete cervical cord lesions. Forty-five percent were caused by falls, 42% by motor vehicle accidents. Serious associated morbidity was 81% in complete cord injuries and 34% in incomplete lesions. Overall mortality was 23%. Complete cord injury mortality rate was 60% in this age group. All patients over 65 years of age with complete cord injuries died.

CONCLUSIONS

Incomplete cervical cord lesions have the best prognosis for return to home and a functional lifestyle. Complete cervical cord injuries in patients older than 50 years of age have a 60% mortality rate. Complete cervical cord injuries in patients over 65 years have a poor prognosis for survival.