Cervical Spinal Cord Injury With And Without The Radiographical Evidence Of Trauma – A Retrospective Comparative Study In Adults
Dr.Nabil Sherif Mahmood,
Department of Radio diagnosis and Imaging,
Kasturba Medical College Manipal,
Manipal – 576104
Tele: +91 820 2922120
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Background : Spinal cord injury without the radiographical evidence of trauma (SCIWORET) is a well described entity in children. This phenomenon is not well described in the adult population. There has been no study till date that compares the prognosis of SCIWORET in adults to those with bony injury.
Aims: To compare the clinical and magnetic resonance imaging (MRI) findings ofcervical spinal cord injury (SCI) with the conventional radiographical evidence of trauma to those with cervical SCI, without the conventional radiographical evidence of trauma (SCIWORET) and to study the importance of MRI and the prevalence of SCIWORET in adult cervical spine trauma.
Settings and Design:A retrospective study on patients who presented to the Department of Radiodiagnosis and Imaging with acute cervical spine trauma over a period of 5 years (between August 2002 and September 2007).
Methods: 50 patients with acute cervical SCI were divided into two groups. Group A included those without radiographical abnormality and Group B included those with bony injury. The epidemiological factors, the total motor scores on admission as well as on follow up, the recovery rate, the average extent of spinal cord oedema and the prevalence of ligamentous injury were compared in both groups.
Statistical Methods used : The statistical analysis was performed using the software SPSS Version 10.0 for Windows.
The paired t test was used to compare the differences in the initial total motor scores, the final total motor scores and the mean recovery rates between both the groups.
Results: SCIWORET was associated with better motor scores and recovery rate when
compared with SCI which is associated with bony injury. Ligamentous injuries were significantly more commonly associated with bony injury.
Conclusion: Cervical SCIWORET is not an uncommon phenomenon in adults. Theoverall outlook is better when compared to cervical spine trauma which is associated with bony injury, as SCIWORET is associated with better motor function and a lesser incidence of ligamentous injury.