The prognosis and the treatment of patients with a C3/4 spinal cord injury.

Twenty patients with a C3/4 spinal cord injury have been treated in our hospital since 1974. There were 15 new patients. The average follow up period was 68 months, ranging from 7 to 162 months. The 15 new cases were classified as Frankel A in nine cases, B in one, and C in five. Frankel A or B were usually accompanied by either an unstable spinal fracture or by spinal canal stenosis at the C3/4 level. Twelve patients received surgery. At the most recent follow up, eight of the 15 patients (53.3%) had improved according to Frankel's classification. Five, all Frankel A on remission, have died between 2 and 156 months after injury. Seven patients required tracheotomy on account of severe respiratory disturbance.