J Korean Soc Spine Surg.  2015 Mar;22(1):1-7. 10.4184/jkss.2015.22.1.1.

The Prognostic Factors of Neurologic Recovery in Spinal Cord Injury

• Seo JH
• Kim HJ
• Lee KY
• Wang L
• Park JW

• KMID: 1800387
• DOI: http://doi.org/10.4184/jkss.2015.22.1.1

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To evaluate and compare the factors affecting recovery of spinal cord injury following cervical and thoracolumbar spine injuries. SUMMARY OF LITERATURE REVIEW: Several authors have reported the factors to predict the prognosis of spinal cord injury, but the objective prognostic factors are still controversial.
MATERIALS AND METHODS
From June 2006 to March 2013, a total of 44 patients with spinal cord injury were evaluated. Prognostic factors analyzed were sex, age, neurologic status, fracture type, time to operation, use of steroid, and signal change on MRI. We analyzed the relation between each factor and the neurologic recovery. The mean follow-up period was 12 months. The neurologic recovery was analyzed by the ASIA impairment scale at the first and the last neurologic examination.
RESULTS
Among 44 patients, 15 sustained complete cord injury while 29 had incomplete cord injury. Significant neurologic recovery using the ASIA impairment scale was evaluated in the incomplete spinal cord injury group. Among this group, the prognosis for Brown-sequard syndrome is better than for central cord syndrome and anterior cord syndrome. There was no significant difference in other factors (fracture site, time to operation, use of steroid or signal change on MRI).
CONCLUSIONS
The prognosis in spinal cord injury is determined by the initial neurologic damage and neurologic recovery is not related with the fracture type, time to operation, use of steroid and signal change on MRI.

Keyword

Spinal cord injury; Prognostic factor; ASIA impairment scale

MeSH Terms

Asia
Brown-Sequard Syndrome
Central Cord Syndrome
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Neurologic Examination
Prognosis
Retrospective Studies
Spinal Cord Injuries*
Spine

Figure

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  Fig. 1. case 1; 53-year-old man with C7 fracture(Vertical compression injury) who become incomplete quadriplegia (Brown-Sequard syndrome) following fall down accident. Steroid administration was done, and operation was done after 24 hours because of pulmonary complication. Shows nerologic recovery (ASIA impairment scale B to D). (A) CT : C7 unstable fracture (B) MRI T2 : central high SI change (Ca, b) Anterior corpectomy C7 & Anterior interbody fusion C6-7.

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  Fig. 2. case 2; 45-year-old man with Fx. & D/L T12-L1 who become complete paraplegia following crushing injury. Steroid administration was done, and operation was done within 24 hours. Shows no nerologic recovery (ASIA impairment scale A to A). (A) CT: Fx. & D/L T12-L1 able fracture (B) MRI T2: SI change is absent (Ca,b) Open reduction & interal fixation, T10-11-L1-2.

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