경수손상 환자의 신경회복에 관한 임상적 분석

Abstract

Neurologic level and change of neurologic function in spinal cord injury patient is valuable in predicting improvement of function and developing a comprehensive rehabilitation plan. Previous studies have grouped spinal cord injury patients according to Frankel's classification system and have reported recovery in terms of changes in their grades.

The purpose of this study is to investigate the neurologic recovery in terms of neurologic levels and to compare the recovery among the conservative care group, the early operation group, and the late operation group.

Fifty two traumatic cervical spinal cord injury patients who were admitted to Severance Hospital and Youngdong Severance Hospital, Yonsei University College of Medicine, between January, 1983, and December, 1993, were studied retrospectively dividing them into 3 groups. Twenty four patients were grouped into the conservative care group and 11 and 17 patients were grouped into the early and the late operated groups, respectively.

The results were as follows:

1) In motor level recovery, 45.8% of patients in group 1, 45.5% of patients in group 2, and 47.1% of patients in group 3 recovered more than 1 root level. There were no statistical difference among 3 groups.

2) In sensory level recovery, 45.8% of patients in group 1, 27.3% of patients in group 2, and 35.3% of patients in group 3 recovered more than 1 root level. There were no statistical difference among 3 groups. But the recovery rate was the lowest in group 2 patients.

3) In 8 cases in operated group, neurologic level became higher immediately after operation. However with exception of 3 cases, all patients recovered to preoperative levels.

In this study, regardless of treatment methods, 46% of cervical spinal cord injury patients improved more than 1 motor root level. The group 2 patients showed the lowest neurologic recovery rate. But the cases were too small to be statistically significant. Prospective study weth large spinal cord injury population is in need.