Y Ronzi1, B Perrouin-Verbe2, O Hamel3, R Gross4. 1. Centre de soins de suite et de réadaptation spécialisé des Capucins, 11, boulevard Jean-Sauvage, 49100 Angers, France; Service de médecine physique et de réadaptation neurologique, centre hospitalier universitaire de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. 2. Service de médecine physique et de réadaptation neurologique, centre hospitalier universitaire de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. 3. Service de neurotraumatologie, centre hospitalier universitaire de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. 4. Service de médecine physique et de réadaptation neurologique, centre hospitalier universitaire de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. Electronic address: raphael.gross@chu-nantes.fr.
Abstract
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed. A statistical analysis provided insights into the prognostic factors associated with the outcomes. RESULTS: Sixty-three patients (mean age 60.1 years) were hospitalized for traumatic SCI with SCS and without instability between January 2000 and December 2012. Falls were the most frequent cause of trauma (77.8%). At admission, most patients had an American Spinal Injury Association Impairment Scale (AIS) grade of C (43.3%) or D (41.7%) and the most frequent neurological levels of injury were C4 (35.7%) and C5 (28.6%). Clinical syndromes were frequently identified (78.6%), with the most frequent being the Brown-Sequard plus syndrome (BSPS) (30.9%), followed by central cord syndrome (CCS, 23.8%). Almost 80% of survivors returned to the community, 60% were able to walk and 75% recovered complete voluntary control of bladder function. Identified prognostic factors of favourable functional outcomes were higher AIS at admission, age under 60 years and presence of BSPS or CCS. CONCLUSION: Traumatic SCI, associated with SCS results mostly in incomplete injuries, can cause various syndromes and is associated with favourable functional outcomes.
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed. A statistical analysis provided insights into the prognostic factors associated with the outcomes. RESULTS: Sixty-three patients (mean age 60.1 years) were hospitalized for traumatic SCI with SCS and without instability between January 2000 and December 2012. Falls were the most frequent cause of trauma (77.8%). At admission, most patients had an American Spinal Injury Association Impairment Scale (AIS) grade of C (43.3%) or D (41.7%) and the most frequent neurological levels of injury were C4 (35.7%) and C5 (28.6%). Clinical syndromes were frequently identified (78.6%), with the most frequent being the Brown-Sequard plus syndrome (BSPS) (30.9%), followed by central cord syndrome (CCS, 23.8%). Almost 80% of survivors returned to the community, 60% were able to walk and 75% recovered complete voluntary control of bladder function. Identified prognostic factors of favourable functional outcomes were higher AIS at admission, age under 60 years and presence of BSPS or CCS. CONCLUSION:Traumatic SCI, associated with SCS results mostly in incomplete injuries, can cause various syndromes and is associated with favourable functional outcomes.
Authors: Tom Inglis; Dan Banaszek; Carly S Rivers; Dilnur Kurban; Nathan Evaniew; Nader Fallah; Zeina Waheed; Sean Christie; Richard Fox; Jean-Marc Mac Thiong; Karen Ethans; Chester Ho; Angelo Gary Linassi; Henry Ahn; Najmedden Attabib; Christopher S Bailey; Michael G Fehlings; Daryl R Fourney; Jérôme Paquet; Andrea Townson; Eve Tsai; Christiana L Cheng; Vanessa K Noonan; Marcel F Dvorak; Brian K Kwon Journal: J Neurotrauma Date: 2020-08-26 Impact factor: 5.269