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Neurologic deterioration after cervical spinal cord injury
J Farmer1, A Vaccaro, T J Albert
1Orthopaedic Surgery Clinic, Uniformed Services, University of the Health Service, Keesler AFB, Biloxi, Mississippi, USA.
Journal of Spinal Disorders
|July 10, 1998
Summary
Neurologic deterioration occurred in 1.84% of cervical spinal cord injury patients. Early surgery, ankylosing spondylitis, sepsis, and intubation were identified as key risk factors.
Area of Science:
- Neurology
- Neurosurgery
- Trauma Care
Background:
- Cervical spinal cord injury (SCI) can lead to secondary neurologic deterioration.
- Understanding the incidence and risk factors for deterioration is crucial for patient management.
Purpose of the Study:
- To determine the incidence of neurologic deterioration in cervical SCI patients.
- To identify associated risk factors for neurologic deterioration after cervical SCI.
Main Methods:
- Retrospective review of cervical SCI patients admitted between 1978 and 1993.
- Analysis of patient characteristics, operative status, risk factors, mortality, and neurologic recovery at 1 year.
- Categorization of patients into minor and major neurologic loss groups.
Main Results:
- Neurologic deterioration was identified in 1.84% (19 of 1,031) of patients.
- Deterioration occurred an average of 3.95 days post-injury.
- Risk factors included early surgery (within 5 days), ankylosing spondylitis, sepsis, and intubation.
Conclusions:
- Neurologic deterioration is a significant concern in cervical SCI, affecting approximately 1.84% of patients.
- Early surgical intervention, ankylosing spondylitis, sepsis, and intubation are associated with increased risk.
- Despite deterioration, most patients showed neurologic improvement at 1 year.