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

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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.

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Author notes

  1. Jinhui Wu, Zhengbo Tao and Yuqing Tang have contributed equally to this work.

Authors and 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

    Jinhui Wu, Zhengbo Tao, Ce Wang, Jun Ma, Tao Lin & Xuhui Zhou

  2. Department of Anesthesiology, Changhai Hospital, Second Affiliated Hospital of Second Military Medical University, 168 Changhai Road, Shanghai, 20043, People’s Republic of China

    Yuqing Tang

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  1. Jinhui Wu
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  2. Zhengbo Tao
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  4. Ce Wang
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  5. Jun Ma
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  6. Tao Lin
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Correspondence to Tao Lin or Xuhui Zhou.

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All authors declared that they have no potential conflict of interest. The manuscript submitted does not contain information about medical device(s)/drug(s).

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The research project was approved by the ethics department of Shanghai Changzheng Hospital, Shanghai. We have consensus with all participants. All the procedures were done under the Declaration of Helsinki and relevant policies in China.

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Wu, J., Tao, Z., Tang, Y. et al. Posterior Hybrid Technique for the Treatment of Traumatic Cervical Spinal Cord Injury with High Signal Intensity on T2WI. JOIO 57, 768–775 (2023). https://doi.org/10.1007/s43465-023-00854-1

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  • DOI: https://doi.org/10.1007/s43465-023-00854-1

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