Influence of blood pressure on acute cervical spinal cord injury without fracture and dislocation: results from a retrospective analysis.

OBJECTIVE: The objective of this study was to investigate the influence of blood pressure on the severity and functional recovery of patients with acute cervical spinal cord injury without fracture and dislocation.

METHODS: A retrospective case control study analyzed the data of 40 patients admitted to the department of orthopedics, Beijing Tiantan Hospital, Capital Medical University from January 2013 to February 2021. They were diagnosed as acute cervical spinal cord injury without fracture and dislocation. Gender, age, height, weight, history of hypertension, post-injury ASIA grade, post-injury mJOA, post-operative mJOA, 1-year follow-up mJOA, pre-operative mean arterial pressure (MAP), intramedullary T2 hyperintensity and hyponatremia were collected. The patients were divided into groups and subgroups based on their history of hypertension and pre-operative MAP. The effects of history of hypertension and pre-operative MAP on the incidence of T2 hyperintensity and hyponatremia, the improvement rate of post-operative mJOA and 1-year follow-up mJOA were analyzed.

RESULTS: Patients with history of hypertension had a lower incidence of intramedullary T2 hyperintensity than patients without history of hypertension (p<0.05). Patients with history of hypertension and patients with higher pre-operative MAP had better neurological recovery at 1-year follow-up (p<0.05).

CONCLUSIONS: Blood pressure has a great influence on acute cervical spinal cord injury without fracture and dislocation. Maintaining higher pre-operative MAP is advantageous for better recovery after spinal cord injury. Attention should be paid to the dynamic managements of blood pressure to avoid the adverse effects of hypotension after spinal cord injury.