경수 손상 환자의 기능 회복

Abstract

Treatment of the fracture and dislocation of the cervical spine is based upon the principle of dislocation reduction and anatomical approximation without causing or increasing any neurological damage.

The question about the neurologic outcome of operative intervention and stabilization versus conservative management remains one of the controversies in medicine today. This study is designed to evaluate the effect of surgical intervention versus conservative treatment in cervical spine injuries in view of functional improvement with comparison of modified Barthel Index (MBI) scores in the two groups and to evaluate the effect of the comprehensive rehabilitation treatment.

Eighty cervical spinal cord injury patients were evaluated, who were admitted to Severance hospital from January 1, 1979 to June 30, 1993. The average MBI score after comprehensive rehabilitation significantly increased from 12.9 to 34.2 in surgically treated group with complete spinal cord injury (p<0.001) and from 17.3 to 27.5 in conservatively treated group with complete spinal cord injury and from 25.7 to 47.1 in surgically treated group with incomplete spinal cord injury (p<0.01) and from 24.9 to 49.2 in conservatively treated group with incomplete spinal cord injury (p<0.01).

However, without regard to the status of completeness in injuries, there is no significant difference in MBI scores between surgically treated and conservatively treated groups.

And frequency of the instability was 13.3% in surgically treated group and 10.0% in conservatively treated group and there was no significant differences in the two groups.