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

• Song KJ
• Moon YJ
• Lee KB

• KMID: 2185373
• DOI: http://doi.org/10.4055/jkoa.2012.47.4.264

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

MeSH Terms

Humans
Incidence
Magnetic Resonance Imaging
Postoperative Complications
Respiratory Insufficiency
Soft Tissue Injuries
Spine
Urinary Bladder, Neurogenic
Urinary Tract Infections

Figure

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  Figure 1 (A) Preoperative C-spine lateral radiograph shows no bony abnormality except bony ossicles on C4-5, C5-6, and C6-7 disc space. (B-D) However, T2-weighted, T-1 weighted sagittal and axial magnetic resonance images show cord signal change on C3-7 and high signal intensity on the prevertebral space and posterior neck muscle group, disc extrusions and anterior longitudinal ligament disruption.

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  Figure 2 Final follow-up C-spine AP (A) and lateral (B) radiographs show the bony fusion on corpectomy, autogenous iliac graft and anterior plate fixation C3-7.

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