Multivariate Analysis For Prognostic Factors On Non-operative Treatment Of Cervical Spinal Cord Injury Without Fracture Or Dislocation

Objective:To analyze the influencing factors in non-operative treatment of cervical spinal cord injury without fracture or dislocation.Methods:A total of 122 patients of cervical spinal cord injury without fracture or dislocation during January 2009 and December 2012 treated by non-operative treatment in our hospital were retrospectively reviewed.84 patients were male and 38 patients were female, average age was 52.37 years (range,18 to 83 years). Their clinical features, such as patient’s age, sex, cause of injury, time from injury to treatment, spine cord injury ASIA grade, MRI type of spine cord injury, range of spine cord injury, effective cervical spinal canal ratio, disc Pfirrmann grade, number of prolapsed discs, injury of disco-ligamentous complex, treatment of high-dose methylprednisolone, were observed. After single factor Logistic regression analysis, muliple factor analysis was performed by multi-factor Logistic regression analysis.Results:For single factor risk analysis, the factors associated with non-operative treatment prognosis of cervical spinal cord injury without fracture or dislocation were MRI type of spine cord injury, range of spine cord injury, effective cervical spinal canal ratio,disc Pfirrmann grade, number of prolapsed discs and spine cord injury ASIA grade (P<0.05). Multiple linear regression analysis showed that the main prognostic factors were:MRI type of spine cord injury, range of spine cord injury, effective cervical spinal canal ratio, disc Pfirrmann grade and spine cord injury ASIA grade according to its intensity (P< 0.05).Conclusion:The main prognostic factors on non-operative treatment of cervical spinal cord injury without fracture or dislocation were MRI type and range of spine cord injury, while effective cervical spinal canal ratio, disc Pfirrmann grade and spine cord injury ASIA grade. The choice of non-operative treatment need to be cautious, only for spinal MRI examinations showed no signal change and the mild localized edema type. The rest was recommended aggressive operative treatment.