The treatment choice of cervical spinal cord injury without radiographic evidence of any bone damage is controversial, and there is to date insufficient evidence to support the treatment standard for this condition. The treatment option has been conservative therapy, while the advances of early surgical treatment have been circumvented to improve the activities of daily lives of involved patients. From October 2000 to August 2002, eleven patients with cervical spinal cord injury, but without bone damage, were treated surgically. Intervals between injury and operation ranged from 8 to 268 days (mean 73.1 days). The postoperative follow up period ranged from 66 to 680 days (mean 408 days). The surgical outcome was satisfactory, and 5 of 11 patients have fully recovered postoperatively and have resumed their daily activities. Although the number in the present study would not be sufficient to determine the surgical indication, surgical treatment early after cervical cord injury seems to be beneficial for the patients to see improvement in their daily activities. Based on our surgical results, the surgical indications for cervical cord injury without radiographic evidence of bone damage are discussed retrospectively with some review of the pertinent literature.
