Neurological Injury and Recovery
It is now generally agreed that there is no correlation between canal compromise and severity of neurological injury. Limb et al21 observed that there was significant correlation between the energy of injury as judged by the injury severity score and the neurological status. Neurological injury occurs at the time of the trauma, rather than as a result of pressure by fragments in the canal. Dall and Stauffer are also of the opinion that the initial severity of partial paralysis did not correlate with the initial canal compromise.
In this series, neurological recovery occurred in all patients with partial paralysis. Neurological recovery appeared to be dependent on the initial kyphosis and 90% recovery was expected in patients with greater than 15 degrees of kyphosis. In this series, the recovery period is taken as 8 months when maximum recovery occurs, although some recovery is still seen after one year. Vertical fractures with maximum canal compromise impacting the neural elements against the posterior bony arch caused the greatest neurological damage with a less favourable recovery pattern. The recovery is better following surgical decompression, as
has also been observed by other authors ¹4.22.23 The overall recovery rate in our patients has varied from 50 to 90%.
