Neurologic recovery in quadriplegia following operative treatment

Records and radiographs of 90 patients suffering complete or motor-complete quadriplegia and treated surgically were reviewed. There were 76 men or boys and 14 women or girls; ages ranged from 15 to 75. Eighty-one were complete quadriplegics and nine had some degree of sensory preservation. After surgery 30 were unchanged, 47 obtained root recovery, and 13 recovered cord function, including two who became ambulatory. Fifty-three of the 74 (71%) patients undergoing decompressive procedures showed neurological improvement while seven of the 16 (49%) patients with fusion and no root decompression had improvement (p less than 0.05). All 26 patients with dislocations underwent closed or open reduction as part of their operative procedures; this did not appear to improve the likelihood of nerve root recovery. Since independence and quality of life may be improved by cord and root recovery, decompression of all neural structures should be considered in cervical spinal cord injury.