Selection of operative approaches for cervical spinal cord injury without radiologic evidence of trauma by imaging scoring system [Görüntüleme Skor Sistemi ile Travmanın Radyolojik Bulgusu Olmaksızın Oluşan Servikal Spinal Kord Yaralanmasında Cerrahi Yaklaşımlar]

Objective: the purpose of this study is to present an imaging scoring system for the patients with spinal cord injury without radiologic evidence of trauma (sciworet),by which the selection of the optimal surgical approaches for this injury needing surgical intervention can be quantified and standardized. methods: the imaging scoring system was designed and established from the retrospective analysis of the 150 patients with cervical myelopathy who underwent different surgical approaches with satisfactory clinical results (>60% recovery rates) using the maximum likelihood discriminance. six imaging indices closely related to the surgical approach were selected for each patient,including segmental instability,congenital spinal canal stenosis,the degree of spinal cord compression,hypertrophy of the ligamentum flava,and the localized or continuous ossification of the posterior longitudinal ligament. then the clinical outcomes of patients with sciworet were evaluated between the patients consistent with the imaging scoring system(group a) and those not consistent with the imaging scoring system (group b) to explore the clinical significance of the scoring system. results: of the two groups of patients with sciworet,there was a significant difference in post-operative joa score (t=-9.626; p＜0.0001) and recovery rate (t=-2.387; p=0.023),showing statistically significant more improvement at the clinical symptoms and joa scores in group a than that in group b. conclusions: for the patients with sciworet needing surgical intervention,the imaging scoring system can provide guidelines for surgeons in choosing the appropriate surgical approach to optimize clinical outcomes and minimize complications. © 2015,ege university press. all rights reserved.