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[Criteria for expert assessment of the injured cervical spine from the neurosurgical viewpoint].

The assessment of cervical injuries in medical expertises can be difficult, because there are sometimes little objective clinical symptoms and radiological signs though the patients pretend to suffer from multiple complaints. A series of 40 neurosurgical expertises has been evaluated: 19 patients (47.5%) had clinical signs of cervical myelopathy, 13 patients (32.5%) had clear radicular syndromes, 7 patients (17.5%) suffered from local cervical syndromes. Clinical symptoms can be objectified by radiological methods, such as MRI, which occasionally can directly show lesions of the cervical cord or the brain stem. Sometimes even in patients with severe neurological deficits there are little radiological alterations. Local pain syndromes were assessed at a reduction in earning capacity of about 20%, radicular syndromes at 20 to 30%, minor grades of myelopathy at 30 to 40% respectively disability, and severe grades of myelopathy at up to 100% resp. incapacity of gainful employment. In our opinion adequate assessment of cervical cord injuries should predominantly base on clinical neurological findings, secondarily on radiological findings.