The early surgical treatment of cervical spinal cord injury without fracture and dislocation

Objective:To evaluate the relationship between the early outcome and timing of surgical treatment in cervical spinal cord injury without fracture and dislocation.Method:107 cases of such injury during the period of August 1992 to July 1997 were analyzed retrospectively.All patients underwent “open door” laminaplasty.As the time from injury to the operation ranged widely,the pre OP condition was considered as the result of conservative treatment.Result:(1)69 patients had spinal cord function recovery stopping and remaining at lower condition after the injury.The rest 38 patients whose recovery not only stopped but also deteriorated.Their condition significantly improved three weeks after the operation.The longer of pre OP history they had,the higher ratio of spinal cord function deterioration occurred.(2)18 patients received surgery one month after the injury.Their post OP spinal cord function at the third week was similar as those patients who were treated conservatively for 4～10 years.(3)All the patients experienced either spinal cord function recovery stopping or deterioration no matter they had either spinal cord shock(67 of 107) or paraplegia and weakness of the extremities(40 of 107).Their function markedly improved three weeks after the operation.Conclusion:(1)Surgical treatment is superior to the conservative treatment on outcome.(2)The early surgery can significantly improve spinal cord condition,shorten the treatment period and avoid the occurrence of late traumatic myelopathy.(3)Although the condition of spinal cord function was different after the injury,the early surgical treatment can help achieve the better result.