Management of cervical spinal cord injury without fracture and dislocation

[Objective]To investigate the management of cervical spinal cord injury without fracture and dislocation.[Method]Sixty-three cases with cervical spinal cord injury without fracture and dislocation were retrospectively reviewed.All the patients were divided into two groups: minor injury group(Ⅰ)and severe injury group(Ⅱ),according to the functional impairment of cervical spinal cord injury.Minor injury group was further divided into Ia and Ⅰb,while severe injury group was subdivided into Ⅱa(nonoperative group) and Ⅱb(operative group).Evaluation of spinal cord function based on ASIA impairment scale and JOA scores were performed at pretherapy and follow up,improvement rates also were calculated respectively.Relationship between improvement of neurological function and spinal cord injury,as well as different therapies was analyzed.[Result]The results of ASIA impairment scale assessment showed neurological function improved better in minor injury group(conservative group),and showed operative treatment was better than conservative therapy in severe injury group.There was no significant difference statistically in improvement rate of JOA scores between Ⅰa and Ⅰb.There were significant difference in improvement rate of JOA scores between Ⅰa or Ⅰb and Ⅱa,as well as Ⅱa and Ⅱb(P0.01).[Conclusion]The efficacy of conservative therapy could be satisfactory in patients with minor cervical spinal cord injury without fracture and dislocation,but it could not be good in severe injury patients.For patient with severe cervical spinal cord injury,the efficacy of operative treatment should be superior to conservative therapy.