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Corresponding Author

krishnamurthy, karthick

Subject Area

Trauma

Article Type

Original Study

Abstract

Background Data: Management of cervical spine fractures has no individualized treatment protocol. Most guidelines are based on the fracture types; our study, being done in a developing nation, has taken into consideration the socioeconomic factors and their implication in making a final treatment plan. Purpose: To compare socioeconomic and functional outcomes of surgical and nonsurgical management of acute cervical spine fractures with severe (ASIA-A and ASIA-B) neurological deficit at a minimum of 12 months postinjury. Study Design: A retrospective observational study. Patients and Methods: The study included a total of 42 patients: 22 were treated operatively (group A) and 20 treated conservatively (group B). Functional outcomes were assessed at a minimum of 12 months postinjury using the SCIM scoring scale. Other parameters, including the number of hospital days, total expenditure at discharge, ICU-related events, deaths within one year, and rehabilitation details, were analyzed. Results: The mean hospital stay in group A was 26 days, with one patient requiring ICU admission with an expenditure of $2707, whereas in group B, the mean days of hospital admission was 40 days with two patients requiring ICU admission incurring an expenditure of $850. ICU-related comorbidities were high in group A. One patient in group A and five in group B died within the first 12 months. Overall mortality within the twelve months following ASIA-A and ASIA-B cervical spine injury was 16.6%, with higher mortality in group B during the early (0–3 months) period. The mean SCIM functional score at 12 months in group A and B was 36.5 and 41.6, respectively (p =  0.2). No statistically significant difference was found in the functional outcome between survivors in both groups at 12 months. Conclusion: One-year survival was better in surgically treated patients with no difference (p = 0.09) in the functional outcome of both groups. Only an early and sustained rehabilitation in both groups help improving their quality of life. (2021ESJ247)

Keywords

cervical fracture, functional outcome, Conservative therapy, cervical fixation

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