Prognostic analysis of traumatic spinal cord injury-related factors: a case control study

Abstract

Abstract Background To systematically analyze the evaluation indexes of injury degree and prognostic improvement in traumatic spinal cord injury. Methods A retrospective analysis of 133 patients with traumatic spinal cord injury admitted to The First Affiliated Hospital of Jinan University from January 2017 to August 2021. The clinical indicators collected include the following: patient gender, age, underlying diseases, time from trauma to operation, length of hospital stay, intraoperative blood loss, cause of injury, whether accompanied with (or multi-segment ) spinal fracture and dislocation, combined disc herniation or not, other sites of the injury, the type of complications, spinal cord injury site, surgical methods, ASIA grade within 72 hours and 6 months after injury, whether received hyperbaric oxygen therapy or high-dose cortisol hormone therapy, mean arterial pressure 3 days after operation, neutrophil/lymphocyte ratio (NLR) within 72h after admission, the length of MR spinal signal change, maximum canal compression (MCC), maximum spinal cord compression (MSCC), and the BASIC score of spinal signal changes. The SPSS software was used to perform Student t-test, Chi-square test, and Logistic regression analysis on the above indicators to find the factors associated with injury severity and prognosis. Results 1) The length of signal change (p < 0.001), MSCC (p < 0.05), MCC (p < 0.05) and NLR within 72h of injury (p < 0.01) were significantly different among groups with different degrees of TSCI injury. 2) MAP (p<0.01), NLR (p<0.01), and the initial degree of injury (p<0.05) showed significant differences between the groups of patients with improved and non-improved prognoses 6 months after TSCI injury. Conclusions The MRI signal change length, MSCC, MCC, and NLR within 72 h after injury are good indicators of the TSCI severity while MAP, NLR, and ASIA can be used to evaluate the prognosis of TSCI patients.