STUDY ON PROGNOSTIC FACTORS FOR NEUROLOGICAL RECOVERY AFTER TRAUMATIC CERVICAL SPINAL CORD INJURY

Dinh Trung Ngo1, , Van Nam Do1
1 Bệnh viện Trung ương Quân đội 108

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Abstract

Objectives: To determine prognostic factors associated with neurological recovery after 1 year in patients undergoing surgery for traumatic cervical spinal cord injury. Methods: A retrospective, descriptive study was conducted on 106 patients with traumatic cervical spinal cord injury who underwent surgery at 108 Military Central Hospital from January 2019 to January 2024. Univariate and multivariate logistic regression were used to determine independent prognostic factors for neurological recovery. Results: The neurological recovery rate after 1 year was 50.9%. Independent prognostic factors associated with neurological recovery included early decompressive surgery, high cervical spinal cord injury, spinal cord lesion length, vasopressor use, tracheostomy, and prolonged ICU stay. A multivariate logistic regression model based on these factors showed good predictive performance with an AUC of 0.849 (p < 0.05). Conclusion: Early assessment of prognostic factors may support risk stratification and guide therapeutic and rehabilitation strategies for surgically treated patients with traumatic cervical spinal cord injury.

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References

1. Lu Y, Shang Z, Zhang W, et al. Global incidence and characteristics of spinal cord injury since 2000 - 2021: A systematic review and meta-analysis. BMC Medicine. 2024; 22(1):285.
2. Covell MM, Naik A, Shaffer A, et al. Social determinants of health impact spinal cord injury outcomes in low-and middle-income countries: A meta-epidemiological study. Neurosurgery. 2024; 94(5):893-902.
3. Michel-Flutot P, Lane MA, Lepore AC, Vinit S. Therapeutic strategies targeting respiratory recovery after spinal cord injury: From preclinical development to clinical translation. Cells. 2023; 12(11):1519.
4. Fehlings MG, Hachem LD, Tetreault LA, et al. Timing of decompressive surgery in patients with acute spinal cord injury: Systematic review update. Global Spine Journal. 2024; 14(3):38-57.
5. Fallah N, Noonan VK, Waheed Z, et al. Pattern of neurological recovery in persons with an acute cervical spinal cord injury over the first 14 days post injury. Frontiers in Neurology. 2023; 14:1278826.
6. Futch BG, Kouam RW, Ugiliweneza B, et al. Demographics, mechanism of injury, and outcomes for acute upper and lower cervical spinal cord injuries: An analysis of 470 patients in the prospective, multi-center, North American Clinical Trials Network registry. Journal of Neurotrauma. 2023; 40(17-18):1918-1927.
7. Kamal R, Verma H, Narasimhaiah S, Chopra S. Predicting the role of preoperative intramedullary lesion length and early decompressive surgery in ASIA impairment scale grade improvement following subaxial traumatic cervical spinal cord injury. Journal of Neurological Surgery Part A: Central European Neurosurgery. 2023; 84(02):144-156.
8. Gour-Provencal G, Mac-Thiong J-M, Feldman DE, Bégin J, Richard-Denis A. Decreasing pressure injuries and acute care length of stay in patients with acute traumatic spinal cord injury. The Journal of Spinal Cord Medicine. 2021; 44(6):949-957.