Prediction of Prognosis Using Modified Frankel Classification in Cervical Spinal Cord Injured Patients.

Abstract

Various evaluation methods for spinal cord injury have been reported. However, the best evaluation method for predicting the prognosis remains controversial. We investigated patients with spinal cord injury using our original evaluation methods between 1990 and 1998. In this study we used two methods for evaluation; one is modified Frankel classification for evaluating the transverse lesion, and the other is the evaluation of the level of lesion of the spinal cord. We studied patients who had been admitted to our center within 7 days of their acute spinal cord injury. The total number of the patients was 294, and they were re-evaluated 6 months after their admission. Our modified Frankel classification showed, 5 of 149 patients (3%) with grade A at admission improved to grades D or E after 6 months. The patients who improved from grades B 1, B 2, and B 3 to higher than grade D were one of 5 patients (20%), 7 of 22 patients (32%), and 8 of 10 patients (80%). The grade B 3 group significantly improved more than the grade B 1 and B 2 groups. Additionally, the patients who improved from grades C 1 and C 2 to higher than grade D were 20 of 33 patients (61%) and 33 of 34 patients (97%). The grade C 2 group significantly improved more than the grade C 1 group. Our modified Frankel classification was useful to predict the neurological improvement in acute spinal cord injured patients 6 months after their accident. (Jpn J Rehabil Med 2001; 38: 29-33)-v Ž|: èò •' '¹ •• ‚Ì •] ‰¿-@ ‚AE ‚µ ‚Ä, ‰ä •X ‚Í "-ƒZ ƒ" ƒ^ •[ ‚Å •l ˆÄ ‚µ ‚½ "AE Ž© ‚Ì •] ‰¿-@ ‚ð-p ‚¢ ‚Ä ‚¢ ‚é. ‰¡ˆÊ‰¡ˆÊ •] ‰¿ ‚AE ‚µ ‚Ä ‰ü-Ç Frankel •ª-Þ ‚ð, •‚ ˆÊ •] ‰¿ ‚AE ‚µ ‚Ä èò •' '¹ •• •‚ ˆÊ "» 'è •] ‰¿-@ ‚ð-p ‚¢, Žó •• OEã7"ú ˆÈ "à ‚É"ü ‰@ ‚µ6ƒJ OEŽˆÈOEŽˆÈ •ã OEo ‰ß ŠÏ Ž@ ‚Å ‚«‚½294-á ‚ð'Î •Û ‚É, ‚» ‚Ì •_ OEo ‰ñ •oe ‚ð‰ð •Í ‚µ-ƒ რ‚Ì-\ OEã-\ 'ª ‚ðŽŽ ‚Ý ‚½. ‰ü-Ç Frankel B 1, B 2, B 3‚© ‚çDˆÈ •ã ‚Ö ‚Ì ‰ñ •oe ‚Í, ‚» ‚ê ‚¼ ‚ê20, 32, 80%‚AE ‚È ‚è, B 3‚ÍB 1, B 2‚É "ä ‚µ ‚Ä-L ˆÓ ‚È •· ‚ð "F ‚ß ‚½. "¯-l ‚É ‰ü-Ç Frankel-{C1, C 2 ‚© ‚çDˆÈ •ã ‚Ö ‚Ì ‰ñ•oe ‚Í61%‚AE97%‚Å ‚ ‚è-L ˆÓ ‚È •· ‚ª ‚Ý ‚ç‚ê ‚½. Frankel •ª-Þ ‚ð•× •ª ‰» ‚· ‚é ‚± ‚AE ‚É ‚ae ‚è, Žl Žˆ-Žˆ-ƒ რ‚Ì‹@ "\ •á ŠQ ‚ðˆê‚ðˆê 'w-¾-Ä ‚É•] ‰¿ ‚Å ‚« ‚é ‚¾ ‚¯ ‚Å ‚È ‚-, ‹} •« Šú èò •' '¹ •• ‚Ì •_ OEo Šw "I ‰ñ •oe ‚É ‚¨‚¢‚¨‚¢ ‚Ä-\ OEã-\ 'ª ‚AE ‚µ‚Ä-L-p ‚Å ‚ ‚é. (ƒŠƒnˆãƒŠƒnˆã Šw2001; 38: 29-33) Key words: èò •' '¹ •• (cervical cord injury), •_ OEo Šw "I-\ OEã (neurological prognosis), •] ‰¿-@ (evaluation method), ‰ü-Ç Frankel •ª-Þ (modified Frankel classification) ‚Í ‚ ¶ ‚ß ‚É èò•' '¹•• ‚Íˆê •u ‚É ‚µ‚Ä ŽlŽˆ‚ÌŽlŽˆ‚Ì Ž©-R ‚ð'D ‚í ‚ê, 'S ‚-‰ñ •oe ‚ª ‚Ý ‚ç‚ê‚È ‚¢-á ‚© ‚ç•à•s ‰Â"\ ‚É‚È ‚é ‚Ü‚Å ‰ñ•oe ‚· ‚é-á ‚ª ‚ ‚è, ‹} •«Šú ‚É‚¨‚¢ ‚Ä ‚ÍŽž ŠÔ ‚AE‚AE ‚à‚ÉŽlŽˆ-‚à‚ÉŽlŽˆ-ƒáƒ ‚ª ‚Ç ‚¤•Ï ‰» ‚µ ‚Ä ‚¢ ‚é ‚© ‚𕳠Šm ‚É •f 'f •E•] ‰¿ ‚· ‚é ‚± ‚AE‚ª •d-v ‚Å ‚ ‚é. ‚» ‚Ì •] ‰¿-@ ‚AE ‚µ ‚Ä ‰ä •X ‚Í1990"N ‚© ‚ç Fran-kel •ª-Þ ‚ð ‚à ‚AE ‚É, "-ƒZ ƒ" ƒ^ •[ ‚Å "AE Ž© ‚É •l ˆÄ ‚µ ‚½ ‰ü-Ç Frankel •ª-Þ ‚ðŽg-p ‚µ‚Ä ‚¢ ‚é. •¡ ‰ñ ‹} •« Šú ‚© ‚çOEo Žž "I