NEUROLOGIC DETERIORATION AFTER CERVICAL SPINAL-CORD INJURY

Neurologic deterioration after cervical spinal cord injury (SCI) at a regional spinal cord center was examined. This study examined the inci dence of neurologic deterioration as well as associated risk factors i n our patient population. Up to 5.8% of cervical SCI patients have bee n noted to deteriorate neurologically after admission. Risk factors ha ve been early surgery, halo application, traction, and Stryker frame r otation. All cervical SCI patients admitted between 1978 and 1993 who had neurologic deterioration were studied for characteristics of their event, operative status, risk factors, mortality, and neurologic retu rn at 1 year postinjury, Patients were divided into minor and major gr oups based on the degree of neurologic loss. Nineteen of 1,031 patient s were identified as neurologically deteriorated (1.84%). There were 8 major and 11 minor group patients. The average time from injury to de terioration was 3.95 days. Of 10 patients undergoing surgery at less t han or equal to 5 days, 8 deteriorated postoperatively. Potential risk factors were ankylosing spondylitis (three patients), sepsis (four pa tients), and intubation (four patients). Neurologic recovery at 1 year showed that 11 of 12 patients were improved. Neurologic deterioration occurred in 1.84% of our patients. Deteriorations were associated wit h surgery at <5 days after injury, ankylosing spondylitis, sepsis, and intubation.