Neurologic outcome in conservatively treated patients with incomplete closed traumatic cervical spinal cord injuries.

STUDY DESIGN

The neurologic outcomes in patients with conservatively managed incomplete closed traumatic cervical spinal cord injuries was evaluated using the motor scoring system and the Frankel classification.

OBJECTIVES

To show that the motor scoring of recovery system combined with functional Frankel grading will make the documentation of final neurologic outcome more accurate for future comparisons of various methods of treatment.

SUMMARY OF BACKGROUND DATA

The influence of surgical and pharmacologic methods of treatment on recovery remains debatable.

METHODS

Sixty-three consecutive patients with incomplete cervical injuries who were admitted to the hospital within 2 days after injury were included. All patients were treated conservatively with 6 weeks of bedrest and 6 weeks of mobilization with neck support.

RESULTS

Five patients had neurologic deterioration, and all but one patient recovered without surgery. The evaluation of 44 patients who were observed for more than 12 months showed that the preservation of sharp sensation below the level of injury was an indicator of a good prognosis in patients whose injuries were classified as Frankel B, and the degree of recovery of these patients according to the motor score system was comparable with that of patients who were classified as Frankel C. All patients classified as Frankel C who did not deteriorate recovered in Frankel grade. All but one of the patients in the Frankel D group recovered full motor power. The degrees of motor deficit and recovery did not correlate with the mechanism or the degree of the injury of the spinal axis.

CONCLUSION

Conservative treatment remains a good option for patients with incomplete cervical cord injuries. It is hoped the current study will be a good basis for comparison of the neurologic outcomes of different treatment modalities.