Factors Affecting Clinical Outcomes in Traumatic Cervical Spine Injuries in Adults: Review of Recent Literature.

Abstract

Introduction: Cervical spine injuries have a catastrophic effect on patients' general health and are associated with significant morbidity and mortality. We evaluate the role of different patient and injury-related factors in the overall outcomes of these injuries.

Materials and methods: Three databases, PubMed, SCOPUS, and EMBASE, were searched, and studies that matched the inclusion and exclusion criteria were reviewed. Out of 2313 total search results, 13 articles were read in detail, and finally, seven articles were included in this review.

Results: Five out of these seven were retrospective studies. The factors assessed in these studies were age, sex, level of injury, intravenous steroid administration, American Spinal Injury Association (ASIA) grade, timing of surgery, blood pressure, and ventilator dependence. There was consensus in the studies on the role of a lower level of injury, lower ASIA grade, and surgical management being associated with better outcomes post-injury. There still needs to be further research through well-designed prospective trials to better ascertain the role of age, timing of surgery, and magnetic resonance imaging findings in their role in cervical spine injury prognosis.

Conclusion: Low ASIA-grade injuries below C5 which are managed surgically favor neurological recovery. Further study is needed to conclusively determine the role of other factors and whether these factors can be modified to aid recovery.