Early outcome of patients with closed cervical spine injury: A retrospective study of 48 cases
Background: Cervical spine injuries have serious implications for patients and physicians. Methods: After excluding minor cervical spine injuries, the medical records and imaging studies of 48 consecutive patients with cervical spine injuries admitted to a single spinal cord injury center, Emdadi hospital, Mashhad, Iran are retrospectively reviewed. In this paper we present our clinical experience in patients with cervical spine injury treated conservatively and surgically and their early outcome during hospitalization. Results: There were 48 patients with cervical spine injury among whom, 23 were treated surgically and 25 treated conservatively. Neurological exam was normal in 24 patients (ASIA grade E). Twenty-four cases had neurological deficit including 17 patients with complete spinal cord injury (ASIA grade A) and 7 patients with ASIA grade C. Ten patients (20.8%) died between 4 and 30 days after injury. Acute respiratory compromise was developed in 12 patients between 9 and 22 days after injury (11.3±7.2 SD) and was to leading cause of death in eight of them. Two patients (4.2%) had obvious clinical neurological deterioration between 12 and 13 days after injury. They died 3 and 15 days after onset of neurological deterioration. Statistical analysis did not identify any significant association between the factors of age and operation and early mortality (Within the first month of injury). Conclusion: Complete neurological deficit, level of spine injury, and spine dislocation are the great predictors of mortality in patients with acute cervical spine injury.