Early treatment of severe injury of cervical spinal cord / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the effects of current major management strategies on early survival of patients with severe injury of cervical spinal cord. Methods A retrospective analysis was done on 532 patients with severe injury of cervical spinal cord (American Spinal Injury Association Grades A and B). The correlations of the early survival and major treatment measures, post-injury temporary immobilization of neck, operation, tracheotomy, systemic nutritional support, administration of glucocorticoid, were analyzed by Binary Logistic Regression. The problems related to the major treatment measures were also analyzed.Results 438 cases survived within 1 month. There was a positive correlation between the early survival and operation and nutritional support. There was a negative correlation between the early survival and tracheotomy.There was not any significant correlation between the early survival and the other 2 measures. The early sur-vival rate for patients of operation was 93.5%, for those without operation was 32. 7%, for those of goodnutrition was 97.8%, for those without good nutrition was 66. 7%, for those of tracheotomy was 58.1%, and for those without tracheotomy was 87.5%. Conclusions For patients with severe injury of cervical spinal cord, active operation and fine systemic nutritional support may increase early survival rate, undue tra-cheotomy may increase the risk of early death, and glucocorticoid may not have an effect on improvement of early survival rate.