The Significance of Soft Tissue Injury in Lower Cervical Spine Trauma

摘要

We retrospectively analyzed consecutive 89 patients for evaluating the correlations between soft tissue damages and cord injuries in the lower cervical spine trauma by Allen's classification. We evaluated the 9 radiologic parameters of soft tissue damage, including anterior longitudinal ligament, inter-vertebral disc, posterior longitudinal ligament (PLL), ligamen-tum flavum, interspinous ligament, supraspinous ligament, posterior muscle group, cord compression, and cord signal changes using plain radiograms and magnetic resonance imaging. We determined the relationship between cord injury and soft tissue damage, injury type and injury severity. The significant correlations were found between cord injury and injury type statistically. Frequent cord injury occurred by compressive extension, combined injury, and distractive extension. Also, the frequency of the cord injury incidence increased as the degree of the soft tissue damage increased and it was statistically significant. In the distractive flexion (0 of 6 cases in stage I, 8 of 35 cases in stage II, and 3 of 5 cases in stage III), cord injury rate increased frequently (P = 0.082). According to the multiple logistic analysis, significant correlations were found between cord injury and soft tissue damage with parameters such as injury type, PLL injury, cord compression, and cord signal changes. We found significant correlations between injury type and cord injury. In distractive extension and distractive flexion, the greater was the injury severity, the higher was the frequency of cord injury. Also, for spinal cord injury, the injury mechanism and also the PLL and posterior neck muscle injuries were regarded as important parameters.