Outcome of decompression surgery for cervical spinal cord injury without bone and disc injury in patients with spinal cord compression: a multicenter prospective study

Study design: A multicenter prospective study comparing the neurological outcome of patients treated by surgical intervention versus conservative treatment for cervical spinal cord injury (CSCI) without bone and disc injury. Objective: To evaluate the neurological outcome of decompression surgery for CSCI without bone and disc injury in patients with spinal cord compression with incomplete paralysis (AIS B, C). Setting: The Japan LHWO Spinal Injuries Center and the other 10 labor accident hospitals in Japan. Methods: Thirty-four patients with AIS B, C and cervical spinal cord compression were classified into either a surgical treatment group or a conservative treatment group. The 34 patients enrolled were equally divided between the groups. Patients with AIS B, C and mild spinal compression were enrolled into another group. Results: The neurological outcome of surgical treatment and conservative treatment for AIS B, C with spinal cord compression was found to be closely similar. In addition, the neurological outcome was also similar to that observed after conservative treatment for AIS B, C in patients presenting with mild spinal cord compression. Conclusions: Surgical treatment was not found to be superior to conservative treatment for CSCI patients without bone and disc injury suffering from spinal cord compression in the acute phase. Spinal Cord (2010) 48, 548-553; doi:10.1038/sc.2009.179; published online 12 January 2010