Evolution of spinal cord injuries due to cervical canal stenosis without radiographic evidence of trauma (SCIWORET): a prospective study

BackgroundTraumatic spinal cord injuries on cervical canal stenosis represent a steadily increasing pathology, of which clinical and functional outcomes remain largely unknown.Material and methodsWe present the results of a prospective study of 20 patients followed for one year who had presented with traumatic spinal cord injury involving initially acute neurological symptoms and cervical canal stenosis defined in the imaging by a Torg ratio < 0.8 and a medullary canal ratio > 0.65, without vertebral fracture.ResultsTraumatic spinal cord injuries on cervical canal stenosis are caused mainly by falls in the elderly population and by unsafe behaviour among younger subjects. Most of the patients present with initially incomplete tetraplegia, and two thirds have centromedullary syndrome. Association of complete tetraplegia with advanced age would seem to be a predictive factor of death in the early post-traumatic period. For incomplete tetraplegics, the main phase of neurological and functional recovery is observed over the first six months. Radiological data and timing of surgery do not appear to affect the prognosis.ConclusionThis study underlines the need for individualized specialized care of patients with spinal cord injuries on cervical canal stenosis, particularly according to their demographic and lesional characteristics.