Multivariate analysis for prognostic factors on non-operative treatment of cervical spinal cord injury without fracture or dislocation / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the factors in the non-operative treatment of cervical spinal cord injury without fracture or dislocation.</p><p><b>METHODS</b>The clinical data of 122 patients with cervical spinal cord injury without fracture or dislocation from January 2009 to December 2012 treated by non-operative treatment were retrospectively reviewed. There were 84 males and 38 females, aged from 18 to 83 years with an average of (52.37 +/- 13.27) years. The clinical features, such as age, gender, cause of injury, time from injury to treatment, ASIA grade of spine cord injury, MRI type of spine cord injury, range of spine cord injury, effective cervical spinal canal ratio, Pfirrmann grade of intervertebral disc herniation, segment of intervertebral disc herniation, intervertebral disc ligament complex injury, treatment of high-dose methyiprednisolone, were observed. Single factor and multiple factor Logistic regression analysis were used in the clinical data in order to analyze the influencing factors of above items to prognosis.</p><p><b>RESULTS</b>For univariate analysis, the factors such as MRI type of spine cord injury, extent of spine cord injury, effective cervical spinal canal ratio, Pfirrmann grade of intervertebral disc herniation, segment of intervertebral disc herniation, ASIA grade of spine cord injury, associated with prognosis (P < 0.05). Multiple linear regression analysis showed that the main prognostic factors including MRI type of spine cord injury, range of spine cord injury, effective cervical spinal canal ratio, Pfirrmann grade of intervertebral disc herniation, ASIA grade of spine cord injury according to its effective intension (P < 0.05).</p><p><b>CONCLUSION</b>The main prognostic factors on non-operative treatment of cervical spinal cord injury without fracture or dislocation were MRI type and extent of spine cord injury, meanwhile, correlate with effective cervical spinal canal ratio, Pfirrmann grade of intervertebral disc herniation, ASIA grade of spine cord injury. It is deliberative to choose no-operative treatment, for it only refers to the patients with the mild localized edema type or no signal change of spinal cord in MRII. Operative treatment shoud be recommended for other patients.</p>