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Diagnostic criteria of traumatic central cord syndrome. Part 2: A Questionnaire Survey among Spine Specialists.


van Middendorp, J J; Pouw, M H; Hayes, K C; Williams, R; Chhabra, H S; Putz, C; Veth, R P H; Geurts, A C H; Aito, S; Kriz, J; McKinley, W; van Asbeck, F W A; Curt, A; Fehlings, M G; Van de Meent, H; Hosman, A J F (2010). Diagnostic criteria of traumatic central cord syndrome. Part 2: A Questionnaire Survey among Spine Specialists. Spinal Cord, 48(9):657-663.

Abstract

Study design:A questionnaire survey.Objectives:To evaluate the need for the introduction of quantitative diagnostic criteria for the traumatic central cord syndrome (TCCS).Setting:An online questionnaire survey with participants from all over the world.Methods:An invitation to participate in an eight-item online survey questionnaire was sent to surgeon members of AOSpine International.Results:Out of 3340 invited professionals, 157 surgeons (5%) from 41 countries completed the survey. Whereas most of the respondents (75%) described greater impairment of the upper extremities than of the lower extremities in their own TCCS definitions, symptoms such as sensory deficit (39%) and bladder dysfunctions (24%) were reported less frequently. Initially, any difference in motor strength between the upper and lower extremities was considered most frequently (23%) as a 'disproportionate' difference in power. However, after presenting literature review findings, the majority of surgeons (61%) considered a proposed difference of at least 10 points of power (based on the Medical Research Council scale) in favor of the lower extremities as an acceptable cutoff criterion for a diagnosis of TCCS. Most of the participants (40%) felt that applying a single criterion to the diagnosis of TCCS is insufficient for research purposes.Conclusion:Various definitions of TCCS were used by physicians involved in the spinal trauma care. The authors consider a difference of at least 10 motor score points between upper and lower extremity power a clear diagnostic criterion. For clinical research purposes, this diagnostic criterion can be considered as a face valid addendum to the commonly applied TCCS definition as introduced by Schneider et al.

Abstract

Study design:A questionnaire survey.Objectives:To evaluate the need for the introduction of quantitative diagnostic criteria for the traumatic central cord syndrome (TCCS).Setting:An online questionnaire survey with participants from all over the world.Methods:An invitation to participate in an eight-item online survey questionnaire was sent to surgeon members of AOSpine International.Results:Out of 3340 invited professionals, 157 surgeons (5%) from 41 countries completed the survey. Whereas most of the respondents (75%) described greater impairment of the upper extremities than of the lower extremities in their own TCCS definitions, symptoms such as sensory deficit (39%) and bladder dysfunctions (24%) were reported less frequently. Initially, any difference in motor strength between the upper and lower extremities was considered most frequently (23%) as a 'disproportionate' difference in power. However, after presenting literature review findings, the majority of surgeons (61%) considered a proposed difference of at least 10 points of power (based on the Medical Research Council scale) in favor of the lower extremities as an acceptable cutoff criterion for a diagnosis of TCCS. Most of the participants (40%) felt that applying a single criterion to the diagnosis of TCCS is insufficient for research purposes.Conclusion:Various definitions of TCCS were used by physicians involved in the spinal trauma care. The authors consider a difference of at least 10 motor score points between upper and lower extremity power a clear diagnostic criterion. For clinical research purposes, this diagnostic criterion can be considered as a face valid addendum to the commonly applied TCCS definition as introduced by Schneider et al.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2010
Deposited On:09 Nov 2010 17:01
Last Modified:05 Apr 2016 14:14
Publisher:Nature Publishing Group
ISSN:1362-4393
Publisher DOI:https://doi.org/10.1038/sc.2010.72
PubMed ID:20585327

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