NEUROLOGIC OUTCOME IN CONSERVATIVELY TREATED PATIENTS WITH INCOMPLETECLOSED TRAUMATIC CERVICAL SPINAL-CORD INJURIES

Study design. The neurologic outcome in patients with conservatively m anaged incomplete closed traumatic cervical spinal cord injuries was e valuated using the motor scoring system and the Frankel classification . Objectives. To show that the motor scoring of recovery system combin ed with functional Frankel grading will make the documentation of fina l neurologic outcome more accurate for future comparisons of various m ethods of treatment. Summary of Background Data. The influence of surg ical and pharmacologic methods of treatment on recovery remains debata ble. Methods. Sixty-three consecutive patients with incomplete cervica l injuries who were admitted to the hospital within 2 days after injur y were included. All patients were treated conservatively with 6 weeks of bedrest and 6 weeks of mobilization with neck support. Results. Fi ve patients had neurologic deterioration, and all but one patient reco vered without surgery. The evaluation of 44 patients who were observed for more than 12 months showed that the preservation of sharp sensati on below the level of injury was an indicator of a good prognosis in p atients whose injuries were classified as Frankel B, and the degree of recovery of these patients according to the motor score system was co mparable with that of patients who were classified as Frankel C. All p atients classified as Frankel C who did not deteriorate recovered in F rankel grade. All but one of the patients in the Frankel D group recov ered full motor power. The degrees of motor deficit and recovery did n ot correlate with the mechanism or the degree of the injury of the spi nal axis. Conclusion. Conservative treatment remains a good option for patients with incomplete cervical cord injuries. It is hoped the curr ent study will be a good basis for comparison of the neurologic outcom es of different treatment modalities.