Neurological and functional outcome in traumatic central cord syndrome

• Published in: Spinal cord Vol. 45; no. 4; pp. 292 - 297
• Main Authors: AITO, S, D'ANDREA, M, WERHAGEN, L, FARSETTI, L, CAPPELLI, S, BANDINI, B, DI DONNA, V
• Format: Journal Article
• Language: English
• Published: London Nature Publishing 01.04.2007; Nature Publishing Group
• Subjects: Activities of Daily Living; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Central Cord Syndrome - physiopathology; Central Cord Syndrome - rehabilitation; Cerebrospinal fluid. Meninges. Spinal cord; Chi-Square Distribution; Female; Follow-Up Studies; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Malformations of the nervous system; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Prospective Studies; Recovery of Function; Retrospective Studies; Traumas. Diseases due to physical agents; Treatment Outcome; Tetraplegia; Nervous system diseases; Prognosis; functional outcome; Vertebral canal; Motor system disorder; FIM; WISCI; Trauma; incomplete tetraplegia; Central nervous system disease; neurological outcome; central cord syndrome; Rehabilitation; Neurological disorder; Spinal cord disease
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101944

Retrospective analysis of in-patient stay and prospective follow-up. To study neurological and functional outcomes after traumatic central cord syndrome (TCCS). Regional Spinal Unit of Florence, Italy. In total, 82 patients, admitted for acute rehabilitation to our Centre (1996-2002) with a diagnosis of TCCS entered the study. Data on admission and discharge were collected for assessments performed at 18 months of injury or later. Data included: cause of injury, gender, type of vertebral lesion, treatment, time of hospitalisation (LoS), ASIA/ISCOS Impairment Scale, neurological examination, functional independence measure (FIM) on admission and discharge. Additional measures included the walking index for spinal cord injuries (WISCI), bladder management, FIM, spasticity on discharge/follow-up and neuropathic pain at follow-up. Correlations were performed on outcome measures in relation to age, treatment, LoS, spasticity and neuropathic pain. Average age was 52 (16-82) years. Causes included falls (47%), road traffic accidents (36%) and sport (7%). Of patients, 45% were treated surgically and 55% conservatively. LoS was 120 days (24-390), but less for those treated without surgery. Patients under 65 years had better outcomes with less neuropathic pain. Neurological and functional recovery was observed on discharge from rehabilitation, which continued in the period following discharge. Spasticity was equally present in all age groups. No difference in outcome was found as a result of spine surgery. Patients with TCCS are older than other spinal cord injured patients, but often show improvement after discharge. Improvement in subjects under 65 years was significantly better than for those over 65 years.