Posterior Hybrid Technique for the Treatment of Traumatic Cervical Spinal Cord Injury with High Signal Intensity on T2WI

Jinhui Wu; Zhengbo Tao; Yuqing Tang; Ce Wang; Jun Ma; Tao Lin; Xuhui Zhou

doi:10.1007/s43465-023-00854-1

Posterior Hybrid Technique for the Treatment of Traumatic Cervical Spinal Cord Injury with High Signal Intensity on T2WI

Indian J Orthop. 2023 Mar 28;57(5):768-775. doi: 10.1007/s43465-023-00854-1. eCollection 2023 May.

Authors

Jinhui Wu^#¹, Zhengbo Tao^#¹, Yuqing Tang^#², Ce Wang¹, Jun Ma¹, Tao Lin¹, Xuhui Zhou¹

Affiliations

¹ Department of Orthopedics, Changzheng Hospital, Second Affiliated Hospital of Second Military Medical University, 415 Fengyang Road, Shanghai, 200003 People's Republic of China.
² Department of Anesthesiology, Changhai Hospital, Second Affiliated Hospital of Second Military Medical University, 168 Changhai Road, Shanghai, 20043 People's Republic of China.

^# Contributed equally.

Abstract

Objective: To evaluate the efficacy of the posterior hybrid technique (PHT) for the treatment of traumatic cervical spinal cord injury without vertebral fracture or dislocation with high signal intensity on T2WI (CSCIH).

Methods: A comparative analysis of clinical efficacy between CSCIH patients who underwent anterior decompression and fusion (ADF) surgery and those who underwent PHT surgery was retrospectively conducted. Demographic characteristics, cervical range of motion (CRM), cross-sectional area of spinal cord (CSASC), spinal canal area residual rate (SCARR), high signal intensity ratio (HSIR), Cervical Japanese Orthopedic Association (CJOA) score, and neck disability index (NDI) were assessed.

Results: Forty-three CSCIH cases with PHT and 46 CSCIH cases with ADF were collected from January 2013 to January 2017. The CRM in patients with PHT was superior to that in patients with ADF at the final follow-up (64.21 ± 18.46° vs. 48.71 ± 19.34°, p = 0.0002). The SCARR also showed greater improvements in the PHT group than in the ADF group (final follow-up: 93.54 ± 11.09% vs. 88.13 ± 10.84%, p = 0.022). Both groups indicated significant improvements in the CSASC and HSIR (p < 0.05); however, no significant differences were observed between the two groups. All patients showed improvements in the CJOA score and the NDI after surgery (p < 0.05). At the 6-month follow-up, the ADF group had better NDI scores than the PHT group (31.17 ± 10.42 vs. 36.78 ± 9.65, p = 0.010), whereas the PHT group exhibited better improvements than the ADF group at the final follow-up (66.86 ± 9.28% vs. 57.67 ± 10.22%, p < 0.0001).

Conclusion: The PHT was as effective as ADF in the treatment of CSCIH, whereas the PHT was superior in the improvement of patients' health-related quality of life and in CRM preservation during the long-term follow-up.

Keywords: Cervical spinal cord injury; Health-related quality of life; High signal intensity; Posterior hybrid technique; Traumatic.

© Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.