Spinal cord injury in cervical spinal stenosis by minor trauma

Yoo, Do Sung; Lee, Sang Bok; Huh, Pil Woo; Kang, Seok‐Gu; Cho, Kyoung Suok

doi:10.1016/j.surneu.2009.05.021

Cited by 29 publications

(19 citation statements)

References 8 publications

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“…A striking feature of older patients is their propensity to suffer TCSCI from seemingly minor trauma (for example, low falls o1 m), because most of the older patients have degenerative changes of the cervical vertebra, including spondylosis and ossification of the posterior longitudinal ligament. Yoo et al 15 suggested that if there is marked stenosis of the cervical spinal canal, even an indirect minor trauma to the neck can cause irreversible changes in the spinal cord. Chikuda et al 16 reported that most of the cervical spinal cord injury cases associated with ossification of the posterior longitudinal ligament were incomplete, without bone injury and caused primarily by low-energy trauma.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of traumatic cervical spinal cord injury in Tianjin, China

Feng

et al. 2012

Spinal Cord

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Study design: A retrospective epidemiological study. Objective: To describe the recent epidemiological characteristics of traumatic cervical spinal cord injury (TCSCI) in adults in Tianjin. Setting: Tianjin Medical University General Hospital. Methods: This study included all TCSCI patients aged X15 years who were admitted to a general hospital from December 2008 to November 2011. Epidemiological characteristics including gender, age, marital status, occupation, etiology, level of injury, severity and America Spinal Injury Association (ASIA) impairment scale were recorded. Results: A total of 143 patients with TCSCI were included in the study. Mean age was 54.6±14.6 years (men 53.5±14.9 years, women 54.2 ± 12.1 years), with a range of 18-87 years, and the male/female ratio was 5:1. The leading cause was falls (49.7%), followed by motor vehicle accidents (36.4%). The most common injury site was C5, accounting for 42%. In all, 74 (51.7%) patients had complications; the most common complication was hyponatremia (30.1%), followed by urinary infection (23.1%), respiratory infection (18.2%), bedsore (9.8%) and deep venous thrombosis (4.9%). As for the severity, ASIA grade D was encountered most frequently. Six patients died, five of whom died from respiratory failure. Conclusion: The epidemiology of TCSCI has its own characteristics. Falls were the leading causes, and TCSCI occurred most frequently in the middle-aged and elders. Therefore, establishing public policies aimed at preventing injuries should focus on falls and more attention should be paid to the aged regarding their vulnerability to low fall. Additionally, complications should be prevented in TCSCI patients. INTRODUCTIONTraumatic spinal cord injury (TSCI) is a life-threatening condition that not only leads to loss of motor and sensory below the level of injury but also results in many dysfunctions of many organs, including the respiratory, gastrointestinal, urinary and autonomic nervous system. It is a substantial burden to the affected individuals, their families and society, because of expenses towards health-care treatments, rehabilitation and lost productivity. 1,2 Of the TSCIs, traumatic cervical spinal cord injury (TCSCI) is one of the most severe and disabling traumatic conditions. Worldwide, the global estimate of TSCI incidence lies between 10.4 and 83 per million per year; 3 however, TCSCI is the most common injury (accounting for 450%). 4,5 Every year, 11 000 cervical spinal cord injury patients require hospitalization. 6 The mean length of stay of patients with TCSCI (161 days for Frankel grade A, B or C and 102 days for grade D) is longer than that for thoracic (161 days for Frankel grade A, B or C and 64 days for grade D) and lumbar (138 days for Frankel grade A, B or C and 70 days for grade D) TSCI. 7 The TCSCI patients have the highest costs, and the complications are significantly of longer duration. 8,9 Approximately 20.6% of the TCSCI cases require tracheostomy because of compromised respiratory function. 10 Additionally, TCSCI mortali...

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Section: Discussionmentioning

confidence: 99%

Epidemiology of traumatic cervical spinal cord injury in Tianjin, China

Feng

et al. 2012

Spinal Cord

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“…In a series of 200 patients seeking treatment for CSS, 63 (31.5%) reported an episode of minor trauma in the preceding 2 weeks. 29 Physiological neck motion, as well as abnormal motion due to cervical instability, which is often associated with spondylosis, 22 predisposes the spine to repeated microtrauma. 23 Tension applied by dentate ligaments preferentially stretches the lateral aspect of the spinal cord on neck flexion, 17 which corresponds to lateral column atrophy noted in autopsy studies.…”

Section: Pathophysiological Features Of Csm In Opllmentioning

confidence: 99%

Diffusion tensor imaging in the assessment of ossification of the posterior longitudinal ligament: a report on preliminary results in 3 cases and review of the literature

Jones

Lerner

Kim

et al. 2011

FOC

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Cervical spondylotic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) is a common neurosurgical disease that carries high morbidity. OPLL and other degenerative processes cause narrowing of the central canal, with subsequent spinal cord injury. Repeated minor trauma and vascular aberrations have been purported to underlie cervical spondylotic myelopathy, although the exact pathophysiological mechanism is unclear. Regardless, detection of early axonal damage may allow more timely surgical intervention and prediction of functional outcome. Diffusion tensor (DT) imaging of the cervical spine is a novel technique with improved sensitivity compared with conventional anatomical MR imaging that is currently available on most clinical scanners. This review describes the theoretical basis, application, and analysis of DT imaging as it pertains to neurosurgery. Particular emphasis is placed on OPLL.

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“…Nakae et al (7) There are numerous studies to investigate the role of CSCS for the development of traumatic SCI in the literature. Yoo et al (9) reported that the risk of developing SCI after trauma is higher in cases with a more stenotic spinal canal. In addition, the rate of improvement of neurological deficits after decompression is lower in patients with a more stenotic spinal canal.…”

Section: Discussionmentioning

confidence: 99%

“…Yoo et al (9) reported that new myelopathy developed without preexisting symptoms in 18 out of 63 cases with SCI associated with CSCS. The most striking finding in our series was that only 2 out of 15 patients had some minor symptoms before trauma, while others were asymptomatic for CSCS.…”

Section: Discussionmentioning

confidence: 99%

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

Eren¹,

Tufan²,

Çetin³

et al. 2017

Bagcilar Medical Bulletin

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Objective: Cervical spinal canal stenosis is a well-known risk factor for spinal cord injury. In some patients, spinal cord injury is the first symptom of spinal stenosis. Therefore, some authors recommend preventive decompression of the spinal canal in asymptomatic patients with spinal stenosis. In this study, we aimed to determine the outcome of patients with spinal cord injury associated with cervical spinal canal stenosis and the rate of previously asymptomatic patients. Material and Methods: Data of 15 consecutive patients were evaluated. Improvement of neurological deficits during followup was accepted as good outcome and mortality and unchanging neurological deficits were accepted as worse outcome. Results: All patients were male, aged between 44 and 85 years. High-energy traumas caused injury in 7 of the cases and low-energy traumas in the others. Nine cases had central cord injury and 6 had other types of traumas. Only 2 patients had been diagnosed with minor symptoms associated with cervical canal stenosis before trauma, while the other patients had been asymptomatic. One patient did not consent to undergo an operation and two others could not be operated because of their general status; the latter 2 patients died. The other 12 patients were decompressed 0 to 40 days after trauma. Two other patients with severe transverse-type cord injury also died postoperatively. The other patients were followed for 1 to 48 months (22.7±17.7 months). In 2 patients, neurological deficits had not improved on last follow-up. Deficits had completely or partly improved in the other patients, including the one who had not accepted the operation. Central cord injury had a significantly better prognosis than other types (p=0.0019). Age, cervical canal diameter, and motor and sensory scores of the American Spinal Injury Association scale, type of trauma, and level of spinal cord injury were not significantly different in the patients with good and worse prognosis. Conclusion:The rate of asymptomatic patients before trauma was very high in patients with spinal cord injury associated with cervical spinal canal stenosis. Therefore, the treatment decision must be carefully assessed in asymptomatic cervical spinal stenosis patients. Catastrophic consequences of spinal trauma may be seen in patients with cervical spinal canal stenosis even in asymptomatic patients. Central cord syndrome had a good prognosis in these patients. Other types of injuries such as transverse and motor types had a worse outcome. Keywords: cervical spinal canal stenosis, spinal cord injuries, spinal cord trauma ÖZET Servikal dar kanal hastalarında radyolojik travma bulgusu olmaksızın servikal omurilik yaralanması: Ardışık 15 olgunun değerlendirilmesi Amaç: Servikal spinal dar kanal omurilik yaralanması için iyi bilinen bir risk faktörüdür. Bazı olgularda kanal darlığının ilk belirtisi omurilik yaralanması olabilir. Bu nedenle bazı yazarlar kanal darlığı olan belirtisiz olgularda önleyici amaçla dekompresyon önermektedir. Bu çalışmada servikal dar ka...

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Spinal cord injury in cervical spinal stenosis by minor trauma

Cited by 29 publications

References 8 publications

Epidemiology of traumatic cervical spinal cord injury in Tianjin, China

Epidemiology of traumatic cervical spinal cord injury in Tianjin, China

Diffusion tensor imaging in the assessment of ossification of the posterior longitudinal ligament: a report on preliminary results in 3 cases and review of the literature

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

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