Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation

Abstract

Purpose The purpose of the study was to evaluate the clinical relationship between cervical spinal canal stenosis (CSCS) and incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation, and to discuss the clinical management of traumatic CSCI. Methods Forty-seven patients with traumatic CSCI without major fracture or dislocation (30 out of 47 subjects; 63.83 %, had an injury at the C3-4 segment) and 607 healthy volunteers were measured the sagittal cerebrospinal fluid (CSF) column diameter at five pedicle and five intervertebral disc levels using T2-weighted midsagittal magnetic resonance imaging. We defined the sagittal CSF column diameter of less than 8 mm as CSCS based on the previous paper. We evaluated the relative and absolute risks for the incidence of traumatic CSCI related with CSCS. Results Using data from the Spinal Injury Network of Fukuoka, Japan, the relative risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 124.5:1. Moreover, the absolute risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 0.00017. ConclusionsIn our results, the relative risk for the incidence of traumatic CSCI with CSCS was 124.5 times higher than that for the incidence without CSCS. However, only 0.017 % of subjects with CSCS may be able to avoid developing traumatic CSCI if they undergo decompression surgery before trauma. Our results suggest that prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

Cervical spinal cord injury in patients with cervical canal stenosis without radiologic evidence of trauma: evaluation of 15 consecutive cases

“…This is not a surprising finding, because a male predominance as high as 72% to 96% was also reported in other series (1,7,10,11,14). This is probably due to male dominance in both spinal cord injury and cervical canal stenosis, especially in OPLL.…”

“…The management of these patients is controversial. Some authors preferred to follow them without any treatment (14), while others recommended preventive decompression surgery to avoid catastrophic consequences of spinal trauma (1). Results of our study showed that most of the patients with SCI-associated CSCS are asymptomatic before injury, and rates of mortality and morbidity are very high.…”

Feasibility and Safety of Cervical Kinematic Magnetic Resonance Imaging in Patients with Cervical Spinal Cord Injury without Fracture and Dislocation

“…Cervical spinal cord injury without fracture and dislocation (CSCIWFD) is a special type of cervical injury that refers to injuries from external force resulting in patients having clinical signs and symptoms but without abnormal radiographic or CT evidence. Most patients are elderly and have radiographic abnormalities such as osteophyte, disc herniation, hypertrophy of the ligamentum flavum, or ossification of the posterior longitudinal ligament, which can cause stenotic spondylotic canal and spinal cord compression.…”

Spinal Disorders as a Cause of Locomotive Syndrome: The Influence on Functional Mobility and Activities of Daily Living

“…The prevalence of cervical myelopathy was 10.1 % in participants with spinal canal diameters of B13 mm. In the elderly, traumatic cervical spinal cord injury without major fracture or dislocation is a common cause of spinal cord injury, with a reported incidence of 10-16 % in North America [80]. In Japan, the annual incidence of traumatic cervical spinal cord injury without major fracture or dislocation has been estimated to be 3000-10,000 persons per year and is increasing dramatically in Japan [80,81].…”