We analyzed three factors involved in fractures and dislocations of the
cervical spine and their relation to the degree of injury of the spinal
cord. The three factors were the space available for the spinal cord at the
level of the injury, the sagittal diameter of the spinal canal at the
uninjured levels, and the Pavlov ratio at the uninjured levels. Of the 288
patients analyzed, eighty-three had a complete injury of the spinal cord,
ninety-two had an incomplete injury of the spinal cord, thirty had an
isolated nerve-root injury, and eighty-three had no neurological deficit.
The mean space available for the spinal cord at the level of the injury was
10.5 millimeters for the patients who had a complete injury of the spinal
cord, 13.1 millimeters for those who had an incomplete injury of the spinal
cord, 15.9 millimeters for those who had an isolated nerve-root injury, and
16.7 millimeters for those who had no neurological deficit. The difference
between the groups was significant (p < 0.001) except for the difference
between the patients who had an isolated nerve-root injury and those who
had no neurological deficit. The mean sagittal diameter of the canal at the
uninjured levels was 16.1 millimeters for the patients who had a complete
injury of the spinal cord, 16.1 millimeters for those who had an incomplete
injury of the spinal cord, 17.9 millimeters for those who had an isolated
nerve-root injury, and 18.1 millimeters for those who had no neurological
deficit. The difference between the patients who had a complete injury of
the spinal cord and those who had an incomplete injury of the spinal cord
and that between the patients who had an isolated nerve-root injury and
those who had no neurological deficit were not significant (p > 0.05).
However, the patients who had a complete injury of the spinal cord and
those who had an incomplete injury of the spinal cord were significantly
different from the patients who had an isolated nerve-root injury and those
who had no neurological deficit (p < 0.001). The mean Pavlov ratio at
the uninjured levels was 0.82 for the patients who had a complete injury of
the spinal cord, 0.84 for those who had an incomplete injury of the spinal
cord, 0.96 for those who had an isolated nerve-root injury, and 0.96 for
those who had no neurological deficit.(ABSTRACT TRUNCATED AT 400 WORDS)