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Acute central and intermediate cervical cord injury
Neurochirurgia
|May 1, 1978
Summary
Older adults with hyperextension cervical spine injuries may experience tetraparesis without clear X-ray findings. This study highlights atypical recovery patterns and potential causes like cervical spondylosis.
Area of Science:
- Neurology
- Orthopedic Surgery
- Radiology
Background:
- Cervical cord contusion can occur in older adults following hyperextension injuries.
- These injuries often present with tetraparesis, particularly affecting the upper limbs.
- Radiographic evidence of cervical spine injury may be absent.
Observation:
- Six cases of cervical cord contusion in patients over 50 are presented.
- Five patients had significant cervical spondylosis; one also had a narrow spinal canal.
- Atypical recovery patterns were noted, with shoulder and elbow movements improving last or not at all.
Findings:
- Upper motor neuron damage is suspected as the cause, potentially due to intermediate cord necrosis or ischemia.
- Pathological findings support the diagnostic value of lateral cervical spine X-rays in hyperextension.
- Laminectomy and myelotomy were deemed ineffective in these cases.
Implications:
- Early diagnosis and understanding of injury mechanisms are crucial for managing cervical cord contusion.
- Hyperextension X-rays are vital for identifying subtle injuries in older patients with spondylosis.
- Steroid therapy may mitigate adverse effects of shock in such cases.