Instrumentation in cervical spine injury: neurological outcome measurement using ASIA impairment scale

Cervical spinal cord injuries make up more than half of all spinal cord injuries. It affects 2-3% of all trauma patients and accounts for 8.2% of all trauma related deaths. Cervical spine surgery has been evolving in terms of surgical technique, equipment, and instrumentation. We have analyzed a series of patients with cervical spine injuries stabilized with various instrumentation techniques. The objective of the study was to evaluate the outcome of instrumentation in cervical spine injury measured on ASIA Impairment Scale. We present prospective observational descriptive analysis, for 36 patients, looking at the clinical and neurological outcomes following instrumentation for cervical spine injuries from Jun 2011 to July 2013. All 36 patients underwent various instrumentation techniques for stabilization and decompression of the cervical spinal cord. The outcome was compared by the ASIA impairment scale. There were 27 (75%) males and 9 (25%) females. The mean age at presentation was 46 years (17-74 years). The most common mode of injury was fall (62%), with ASIA grade C and D, 31% each. C5/6 level was the most common level (26.2%) of injury. The timing of surgery ranged between 8 - 270 days from injury. Out of thirty-six, thirty-two patients were available for follow-up. Eighteen of these patients had spinal cord injury and improved by at least one ASIA grade. It is concluded that instrumentation in cervical spine injury is an effective surgical procedure with minimal post-operative morbidity for the management of cervical injury, allowing an improved physiologic environment for maximal neurologic improvement. The post-operative outcome measured on ASIA impairment scale was comparable to international study.