J Korean Orthop Assoc.  2014 Feb;49(1):50-57. 10.4055/jkoa.2014.49.1.50.

Neurologic and Functional Outcomes after Traumatic Central Cord Syndrome

• Song KC
• You JW
• Kim HH
• Sohn HM

• KMID: 2185252
• DOI: http://doi.org/10.4055/jkoa.2014.49.1.50

Abstract

PURPOSE
The purpose of this study was to determine the direction for treatment and to evaluate factors influencing improvement by comparison of neurologic and functional outcomes of surgical treatment and conservative treatment for traumatic central cord syndrome.
MATERIALS AND METHODS
A total of 28 patients, who were available for follow-up for at least more than one year from January 2005 to December 2008, who were diagnosed as traumatic central cord syndrome were analyzed retrospectively. Fifteen patients underwent surgical treatment (group 1), and 13 patients received conservative treatment (group 2). Maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were used for radiologic assessment, and American Spinal Injury Association (ASIA) motor score, Japanese Orthopaedic Association (JOA) score, and neck disability index (NDI) were used for assessment of functional outcomes.
RESULTS
The mean MCC was 47.2%, mean MSCC was 20.0%, and mean ASIA motor scale was 92.0 (group 1: 92.9, group 2: 90.9) at the final follow-up. The mean JOA score was 12.8 (group 1: 14.0, group 2: 11.4) and mean NDI was 25.0 (group 1: 25.7, group 2: 24.3) at the final follow-up.
CONCLUSION
It is concluded that if a patient with traumatic central cord syndrome is young, with a high energy injury combined with fractures, and has severe spinal compression and mild initial neurologic defect, early surgical treatment would be needed as soon as possible.

Keyword

spinal cord injuries; central cord syndrome; cervical spine; treatment outcome

MeSH Terms

Asia
Asian Continental Ancestry Group
Central Cord Syndrome*
Follow-Up Studies
Humans
Neck
Retrospective Studies
Spinal Cord Compression
Spinal Cord Injuries
Spinal Injuries
Treatment Outcome

Figure

• 

  Figure 1 Sagittal T2-weighted magnetic resonance image shows parameters used for measurement of midsagittal diameter, maximum canal compromise (MCC), and maximum spinal cord compression (MSCC). The following measurements were obtained: spinal cord diameter one segment above the end of spinal stenosis (da), sagittal diameter of the spinal canal one segment above the stenotic segment (Da), sagittal diameter of the spinal cord (di) and spinal canal (Di) at the point of maximum compression, sagittal diameter of the spinal canal one segment below the stenotic segment (Db), the diameter of the spinal cord below the stenotic segment (db). MCC and MSCC were calculated according to the formulas. MCC=[1-Di/{1/2(Da+Db)}]×100, MSCC=[1-di/{1/2(da+db)}]×100.

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