[Features of the spinal cord injury in distractive flexion and compressive extension cervical spine trauma].

OBJECTIVES: 1) to assess neurological status in patients with distractive flexion and compressive extension cervical spine injuries; 2) to determine the relationship between neurological recovery and the patterns of cervical spine injuries.

MATERIAL AND METHODS: Prospectively collected data on 78 persons with traumatic distractive flexion and compressive extension cervical spine injuries. These patients were treated in Kaunas University of Medicine Hospital between 1998 and 2000. The study included 18 (23.1%) females and 60 (76.9%) males. The age range was 16-80 years, mean age was 46.6 years. Cervical spine injuries in all patients were visualized at using Computed tomography and radiography. The cervical spine injury patterns were recognized by the Ferguson-Allen's classification. We divided these patients into two groups: the first group included patients who had sustained distractive flexion cervical spine injuries; the second group included patients who had sustained compressive extension cervical spine trauma. We assessed neurological status of these patients after admission to hospital in the average of four hours after an accident. Motor and sensory evaluation was conducted using the guidelines established by the American Spinal Cord Injury Association. Forty-nine patients were investigated in the average of four years after trauma and treatment. We assessed their neurological status and determined the relationship between neurological recovery and the patterns of cervical spine injury.

RESULTS: Forty-eight (61.5%) patients had distractive flexion cervical spine injuries (the first group) and 30 (38.5%) had compressive extension trauma (the second group). We compared patients from the first and the second groups and did not find any difference among an accident circumstances (p>0.05), the level of the cervical spine injury (p>0.05) and neurological status at the early period after a trauma (p>0.05). Eight (16.7%) patients died from the first group, 5 (16.7%) from the second group due to severe spinal cord injury (p>0.05). Thirty patients from the first group, and 19 patients from the second group were investigated in the late posttraumatic period (average four years). We performed statistical analysis of these patients and did not find any difference between the accident circumstance (p>0.05), the level of the cervical spine injury (p>0.05), displacement of the vertebra body (p>0.05), neurological status and did not determine the relationship between neurological recovery and the patterns of cervical spine injuries.

CONCLUSIONS: Neurological status of the patients with distractive flexion and compressive extension cervical spine injuries did not differ. The relationship between neurological recovery and the patterns of cervical spine injuries did not exist.