Importance of checking prehospital neurological findings to reveal incidence of spinal cord concussion

Objective: To clarify the incidence and characteristics of spinal cord concussion in an urban city in Japan. Methods: The current retrospective study was conducted by reviewing the medical records of patients with spinal cord injuries admitted between January 2007 and December 2010. The subjects were divided into two groups: a spinal cord concussion group and a spinal cord injury group. Results: There were 36 patients with spinal cord injuries admitted during this period. Among them, there were 8 patients with spinal cord concussions. No significant differences were apparent between the two groups with regard to sex, mechanism of injury, Glasgow Coma Scale, incidence of shock, inhospital Frankel classification, level of spinal cord injury, frequency of vertebral dislocation/fracture, surgery and the survival rate. However, the mean age in the spinal cord concussion group was lower than that in the spinal cord injury group. The systolic blood pressure, the heart rate and the diameter of minimum spinal canal in the concussion group were all higher than those in the spinal cord injury group. Half of the subjects in the spinal cord concussion group demonstrated immediate neurological improvement between prehospital and inhospital findings, however none of the subjects in the spinal cord injury group demonstrated such improvement. This difference was statistically significant. Conclusion: Spinal cord concussion is not rare in urban Japan. Checking neurological findings at the scene leads to the revelation of the true high incidence of spinal cord concussion among spinal cord injuries.