J Korean Soc Spine Surg.  2015 Dec;22(4):133-139. 10.4184/jkss.2015.22.4.133.

The Relationship of Minor Trauma with the Surgical Outcome in Patients with Cervical Myelopathy

• Kim MW
• Lee KY
• Kim DR
• Jung YH
• Im CS

• KMID: 2150539
• DOI: http://doi.org/10.4184/jkss.2015.22.4.133

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To determine the influence of trauma on the neurologic course in patients who have undergone surgery for cervical myelopathy. SUMMARY OF LITERATURE REVIEW: The postsurgical outcomes were worse from trauma in patients who had a cervical ossification of the posterior longitudinal ligament (OPLL) or cervical canal stenosis, in comparison with patients who did not.
MATERIALS AND METHODS
The study was conducted on 70 patients who had undergone surgery due to cervical myelopathy from January 2004 to December 2013 and had at least 1 year of follow-up. Depending on trauma history, the patients were divided into two groups, and their radiological (simple radiographic, computed tomographic, and magnetic resonance imaging) and clinical (Japanese Orthopaedic Association [JOA] score, motor power of upper extremities) results were compared retrospectively.
RESULTS
Among 70 patients in total, 18 patients were in the trauma group and 52 were in the non-trauma group, and all cases in the trauma group had a history of minor trauma (11 cases of drivers traffic accidents, 4 cases of slipping and falling, 2 cases of minor pedestrian accidents, and 1 case of falling). Radiologically narrower diameter of the spinal canal showed statistically significant difference between two groups (p=0.042). The JOA scores before and after surgery and the recovery rate did not have a clinically meaningful difference with trauma. However, the degree of motor improvement was significantly higher for the trauma group within 1 week after surgery (p=0.040).
CONCLUSIONS
Minor trauma itself may adversely affect the patients' clinical courses.

Keyword

Trauma; Myelopathy; Recovery

MeSH Terms

Accidents, Traffic
Constriction, Pathologic
Follow-Up Studies
Humans
Longitudinal Ligaments
Retrospective Studies
Spinal Canal
Spinal Cord Diseases*

Figure

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  Fig. 1. Clinical outcomes (1). Japanese Orthopedic Association scoring System (JOA score).

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  Fig. 2. Clinical outcomes (2). The muscle grading scale of upper extremity over follow up periods.

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