The Efficacy of Non-operative and Operative Intervention in Regards to Motor Recovery in the Setting of Cervical Spinal Cord Injury

An assessment of nonoperative and operative intervention inregards to neurological improvement following traumatic closed cervical spinal cord injury (CSCI). A retrospective evaluation of a cohort of patients with a CSCI from C3 to T1 was reviewed. The analysis included a total of 13 eligible patients. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data included patients'' age; level of injury, neurologic exam according to the Frankel grading system, the performance of surgery, the mechanism and timing of the CSCI decompression, and motor index score (MIS). Ninety-two percent of the patients were male with the mean age of 28.2 ± 11.5. Before treatment, 10/13 patients (77.0%) had functionally complete neurological deficits below the level of injury. The median interval from injury to surgery was 16 days. Eight patients underwent surgical intervention and five were treated nonoperatively. The median length of follow-up was 14 months after surgery (Range: 7 - 93 months). Spinal cord functional improvement was observed in 2/8 (25%) of the surgically managed patients and in 4/5 (80%) of the patients treated nonoperatively. Root recovery was observed in 6/8 (75%) of the patients who were treated surgically and 4/5 (80%) of the patients treated nonoperatively. Some degree of motor score improvement occurs following a closed cervical spinal cord injury with or without operative surgery in the follow up period.