[Cervical spine trauma and spinal cord injury: the deaths caused by spinal cord swelling].

OBJECTIVE: To investigate clinical status features of the patient's who died from spinal cord and brain swelling.

MATERIAL AND METHODS: Retrospectively collected data on 67 persons with severe spinal cord injury. These patients were treated and died in Kaunas University of Medicine Hospital between 1995 and 2003. The death reasons were determined after autopsy. The study included 2 (3%) females and 65 (97%) males. The age range was 16-82 years, mean age was 49.6 years. Cervical spine injuries in all patients were visualized at computed tomography and radiography. The cervical spine injury patterns were determined using Ferguson-Allen's classification. Motor and sensory evaluation after admission to hospital was conducted using the guidelines established by the American Spinal Cord Injury Association. From this group of patients, 48 cases were selected with spinal cord swelling as the reason of death. We divided these patients into two groups; 21 patients with C4-C5 neurological level were in the first group and 27 persons with C6-Th1 neurological level were in the second group.

RESULT: . We compared the patients from the first and the second groups and did not find any difference between their age, the patterns of the accidents, the patterns of the cervical spine injuries (p>0.05), clinical status after admission to hospital and six hours before patient's death (p>0.05). Patients, who died from spinal cord swelling, had alterations in cardiopulmonary function before their death. The patients from the first group died on average in 80 hours after the accident; the patients from the second group died on average in 146 hours after the trauma (p<0.05).

CONCLUSIONS: Patients, who died from spinal cord swelling, had distinct respiratory failure before their death. Alterations of the clinical status of patients with C4-C5 neurological level were faster.