Nerve root recovery in complete injuries of the cervical spine

Thirty-six patients with complete quadriplegia were reviewed. Twenty-two underwent surgery, and 14 did not. There were 11 burst fractures and 3 extension fracture-dislocations, which were treated with anterior decompression and rigid plate fixation. There were 22 flexion injuries that were treated w...

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Bibliographic Details
Published in:Spine (Philadelphia, PA. 1976) PA. 1976), 1991-10, Vol.16 (10S), p.S518-S521
Main Authors: YABLAN, I. G, PALUMBO, M, SPATZ, E, MORTARA, R, REED, J, ORDIA, J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Bone Wires
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - injuries
Female
Fractures, Bone - diagnostic imaging
Fractures, Bone - physiopathology
Fractures, Bone - therapy
Humans
Injuries of the limb. Injuries of the spine
Male
Medical sciences
Middle Aged
Motor Activity
Movement
Paralysis - etiology
Paralysis - physiopathology
Quadriplegia - etiology
Quadriplegia - physiopathology
Radiography
Sensation
Spinal Injuries - complications
Spinal Injuries - diagnostic imaging
Spinal Injuries - physiopathology
Spinal Injuries - therapy
Spinal Nerve Roots - injuries
Spinal Nerve Roots - physiopathology
Traction
Traumas. Diseases due to physical agents
Wound Healing
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Description
Summary:Thirty-six patients with complete quadriplegia were reviewed. Twenty-two underwent surgery, and 14 did not. There were 11 burst fractures and 3 extension fracture-dislocations, which were treated with anterior decompression and rigid plate fixation. There were 22 flexion injuries that were treated with posterior stabilization using Kirschner-wire tension band fixation, Harrington compression hooks, or Halifax laminar hooks. The non-operative group was treated with skeletal traction with skull tongs for 6-12 weeks followed by the application of a hard collar or halo vest for 3 months. Of the 22 patients who underwent surgery, 32% descended one level and 18% two levels. In the nonoperative group, only one patient descended one level. It is concluded that the heretofore pessimistic outlook regarding complete quadriplegia is unwarranted and that a more aggressive approach may result in a better functional outcome.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-199110001-00012