J Korean Orthop Assoc.  2012 Aug;47(4):264-270. 10.4055/jkoa.2012.47.4.264.

Clinical Analysis of Lower Cervical Spine Injury according to Injury Mechanism: Data of 277 Surgical Patients

Affiliations
  • 1Department of Orthopedic Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Research Institute of Clinical Medicine, Biomedical Science Institute, Jeonju, Korea. osdr2815@naver.com

Abstract

PURPOSE
To analyze the incidence and treatment outcomes of lower cervical spine injury since there is no long term, large Korean data available.
MATERIALS AND METHODS
We analyzed 277 patients with lower cervical spine injury who underwent surgical treatments between May 1994 and October 2008. The injury types are based on Allen's classification, and neurologic injury was classified as complete, incomplete cord injury, root injury and no neurologic status. We analyzed postoperative complications, neurologic recovery and the relief of pain.
RESULTS
Distractive-extension injury occurred most commonly in 140 patients (50.5%). Neurologic injury was detected in 232 cases (83.8%); 46 (16.6%) complete cord injury; 154 (55.6%) incomplete cord injury; and 32 (11.6%) root injury. Incomplete cord injury of distractive extension injury was poorly recovered. Clinical outcomes demonstrated improvement compared with the preoperative values in mean visual analogue scale. Complications were respiratory failure, neurogenic bladder, urinary tract infection and gastritis.
CONCLUSION
This study showed the highest incidence of distractive extension injury and neurologic injury contrary to previous studies. This result was caused by the use of plain radiograph to establish Allen's classification in the past. Therefore, we suggest the use of magnetic resonance imaging for evaluating soft tissue injury with Allen's classification to achieve accurate assessment.

Keyword

Allen classification; Korean data; lower cervical spine injury
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