Acute central cervical cord injury: the effect of age upon prognosis

In this clinical study, a total of 89 consecutive patients with acute cervical cord injury was analysed retrospectively. There were 29 patients aged 60 years and over, accounting for 32.6% of all the cases. All the patients were followed up from 1 to 15 years, with an average of 6 years and 4 months. Among the patients of 60 years and over, 27 (93.1%) had both upper and lower extremities involved, compared with 40 (66.7%) of those under 60 years (P<0.05). Also among the older group, 24 had radiographic findings of severe cervical spinal degeneration, a higher incidence than in the patients under 60 years (P<0.05). There were two deaths in patients of 60 years and older. The average American Spinal Injury Association (ASIA) scores in both the younger and older groups at final follow-up were significantly larger (P<0.01) than on admission, but the age of the patients was negatively correlated with the ASIA scores both on admission (P<0.05) and at final follow-up (P<0.01). The ASIA score was significantly lower (P<0.01) in patients aged 60 years and over than in those younger than 60 years both on admission and at final follow-up. Patients aged 60 years and over with acute central cervical cord injury have a poorer prognosis although they may experience significant neurological improvement.