Acute central cervical cord injury: the effect of age upon prognosis

In this clinical study, a total of 89 consecutive patients with acute cervi cal cord injury was analysed retrospectively. There were 29 patients aged 6 0 years and over, accounting for 32.6% of all the cases. All the patients w ere followed up from 1 to 15 years, with an average of 6 years and 4 months . Among the patients of 60 years and over, 27 (93.1%) had both upper and lo wer extremities involved, compared with 40 (66.7%) of those under 60 years (P < 0.05). Also among the older group, 24 had radiographic findings of sev ere cervical spinal degeneration, a higher incidence than in the patients u nder 60 years (P < 0.05). There were two deaths in patients of 60 years and older. The average American Spinal Injury Association (ASIA) scores in bot h the younger and older groups at final follow-up were significantly larger (P < 0.01) than on admission, but the age of the patients was negatively c orrelated with the ASIA scores both on admission (P < 0.05) and at final fo llow-up(P < 0.01). The ASIA score was significantly lower (P < 0.01) in pat ients aged 60 years and over than in those younger than 60 years both on ad mission and at final follow-up. Patients aged 60 years and over with acute central cervical cord injury have a poorer prognosis although they may expe rience significant neurological improvement. (C) 2001 Elsevier Science Ltd. All rights reserved.