Original Article

European Spine Journal

, Volume 22, Issue 10, pp 2228-2231

Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation

  • Tsuneaki TakaoAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center Email author 
  • , Yuichiro MorishitaAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
  • , Seiji OkadaAffiliated withDepartment of Orthopaedic Surgery, Kyushu University
  • , Takeshi MaedaAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
  • , Fumihiko KatohAffiliated withDepartment of Orthopaedic Surgery, Chubu Rosai Hospital
  • , Takayoshi UetaAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
  • , Eiji MoriAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
  • , Itaru YugueAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
  • , Osamu KawanoAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center
    • , Keiichiro ShibaAffiliated withDepartment of Orthopaedic Surgery, Spinal Injuries Center

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Abstract

Purpose

The purpose of the study was to evaluate the clinical relationship between cervical spinal canal stenosis (CSCS) and incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation, and to discuss the clinical management of traumatic CSCI.

Methods

Forty-seven patients with traumatic CSCI without major fracture or dislocation (30 out of 47 subjects; 63.83 %, had an injury at the C3–4 segment) and 607 healthy volunteers were measured the sagittal cerebrospinal fluid (CSF) column diameter at five pedicle and five intervertebral disc levels using T2-weighted midsagittal magnetic resonance imaging. We defined the sagittal CSF column diameter of less than 8 mm as CSCS based on the previous paper. We evaluated the relative and absolute risks for the incidence of traumatic CSCI related with CSCS.

Results

Using data from the Spinal Injury Network of Fukuoka, Japan, the relative risk for the incidence of traumatic CSCI at the C3–4 segment with CSCS was calculated as 124.5:1. Moreover, the absolute risk for the incidence of traumatic CSCI at the C3–4 segment with CSCS was calculated as 0.00017.

Conclusions

In our results, the relative risk for the incidence of traumatic CSCI with CSCS was 124.5 times higher than that for the incidence without CSCS. However, only 0.017 % of subjects with CSCS may be able to avoid developing traumatic CSCI if they undergo decompression surgery before trauma. Our results suggest that prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

Keywords

Cervical spinal canal stenosis Traumatic cervical spinal cord injury without major fracture or dislocation MRI Relative risk Absolute risk Prophylactic surgical management