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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(04): 641-649
DOI: 10.1055/s-0044-1788062
Original Article

Clinical Outcome and Predictors of Traumatic Cervical Injury: A Prospective Observational Study

Suresh Kumar Jaiswal 
1   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Bal Krishna Ojha 
1   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Somil Jaiswal 
1   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Ankur Bajaj
1   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Abstract

Introduction Traumatic cervical spine injuries (CSIs) have an incidence of 1.7 to 8% among traumatic brain injury (TBI) patients and should be a pivotal part of its neurological examination. Prognosis of cervical spine insult in TBI depends on several epidemiological and clinical factors which need to be considered during the management of these injuries. This study aims to analyze the outcomes of patients with CSI and its associated predictors.

Materials and Methods A prospective observational study was conducted among 63 patients of traumatic CSI admitted at a tertiary care center of Lucknow, Uttar Pradesh, India. All patients underwent a clinical assessment using the American Spinal Injury Association, Functional Independence Measure (FIM), and Barthel Index scoring and grading at admission, 1, and 4 months, respectively. All patients at the facility underwent magnetic resonance imaging (MRI). Midsagittal T1- and T2-weighted sequences were used to measure the degree of spinal cord injury (SCI) impairment. Patients were followed for outcome assessment.

Results There was a significant difference in the median values of Barthel Index and mean values of FIM preoperatively and at 4 months' follow-up. There was a significant improvement in the neurological outcome of the patients after admission, at 1, and 4 months' follow-up. Out of the 30 patients who had improvement in the neurological outcome, majority (26) had edema present in less than equal to 2 segments and this was statistically significant. The overall FIM score was significantly higher among those with ≤ 2 segment edema as compared with those with > 2 segments.

Conclusion The study concludes that incomplete injury, edema on MRI imaging less than equal to 2 segments, and no listhesis are predictors of neurological and functional improvement in patients with traumatic cervical spinal injuries.

Keywords

anterior cervical corpectomy and fusion - American Spinal Injury Association - spinal cord injury - magnetic resonance imaging - anterior cervical discectomy and fusion - Functional Independence Measure - cervical spinal cord injury - computed tomography - factor influencing - recovery


Publication History

Article published online:
11 July 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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