Header

UZH-Logo

Maintenance Infos

Diagnostic criteria of traumatic central cord syndrome. Part 3: descriptive analyses of neurological and functional outcomes in a prospective cohort of traumatic motor incomplete tetraplegics


Pouw, M H; van Middendorp, J J; van Kampen, A; Curt, A; van de Meent, H; Hosman, A J F (2011). Diagnostic criteria of traumatic central cord syndrome. Part 3: descriptive analyses of neurological and functional outcomes in a prospective cohort of traumatic motor incomplete tetraplegics. Spinal Cord, 49(5):614-622.

Abstract

Objectives:
To compare the neurological recovery and functional outcomes between traumatic central cord syndrome (TCCS) patients and motor incomplete tetraplegic patients.
Setting:
European Multicenter Study of human spinal cord injury.
Methods:
In 248 traumatic motor incomplete tetraplegics, initial phase (0–15 days) American Spinal Injury Association (ASIA) impairment grading, upper and lower extremity motor scores (UEMS and LEMS), upper and lower sensory scores and chronic phase (6 or 12 months) neurological outcomes were analyzed. In addition, chronic phase self-care and indoor mobility Spinal Cord Independence Measure (SCIM) items were studied. Tetraplegics were subdivided into three groups: (1) non-TCCS group (UEMSgreater than or equal toLEMS), (2) intermediate-TCCS group (UEMS=(1–9 points)<LEMS) and (3) TCCS group (UEMS=(greater than or equal to10 points)<LEMS). Student's t-tests and χ2-tests were applied.
Results:
A total of 89 non-TCCS subjects (AIS D, n=28), 62 int-TCCS (AIS D, n=43) and 97 TCCS (AIS D, n=80) subjects were analysed. Although minimal significant differences in chronic phase LEMS and UEMS outcomes were identified between TCCS and non-TCCS patients after stratification by the AIS grade, our data showed no significant differences in functional upper and lower extremity outcomes at 6 or 12 months post-injury.
Conclusion:
The AIS grading system, and not the diagnosis TCCS, continues to be the best available prognostic parameter for neurological and functional outcomes in motor incomplete tetraplegics. The authors recommend that for future outcome studies in motor incomplete tetraplegia, patients should not be selected based on, or stratified by, the diagnosis TCCS.

Abstract

Objectives:
To compare the neurological recovery and functional outcomes between traumatic central cord syndrome (TCCS) patients and motor incomplete tetraplegic patients.
Setting:
European Multicenter Study of human spinal cord injury.
Methods:
In 248 traumatic motor incomplete tetraplegics, initial phase (0–15 days) American Spinal Injury Association (ASIA) impairment grading, upper and lower extremity motor scores (UEMS and LEMS), upper and lower sensory scores and chronic phase (6 or 12 months) neurological outcomes were analyzed. In addition, chronic phase self-care and indoor mobility Spinal Cord Independence Measure (SCIM) items were studied. Tetraplegics were subdivided into three groups: (1) non-TCCS group (UEMSgreater than or equal toLEMS), (2) intermediate-TCCS group (UEMS=(1–9 points)<LEMS) and (3) TCCS group (UEMS=(greater than or equal to10 points)<LEMS). Student's t-tests and χ2-tests were applied.
Results:
A total of 89 non-TCCS subjects (AIS D, n=28), 62 int-TCCS (AIS D, n=43) and 97 TCCS (AIS D, n=80) subjects were analysed. Although minimal significant differences in chronic phase LEMS and UEMS outcomes were identified between TCCS and non-TCCS patients after stratification by the AIS grade, our data showed no significant differences in functional upper and lower extremity outcomes at 6 or 12 months post-injury.
Conclusion:
The AIS grading system, and not the diagnosis TCCS, continues to be the best available prognostic parameter for neurological and functional outcomes in motor incomplete tetraplegics. The authors recommend that for future outcome studies in motor incomplete tetraplegia, patients should not be selected based on, or stratified by, the diagnosis TCCS.

Statistics

Citations

6 citations in Web of Science®
7 citations in Scopus®
Google Scholar™

Altmetrics

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:2011
Deposited On:28 Jan 2012 19:49
Last Modified:05 Apr 2016 15:30
Publisher:Nature Publishing Group
ISSN:1362-4393
Publisher DOI:https://doi.org/10.1038/sc.2010.171
PubMed ID:21151190

Download

Full text not available from this repository.
View at publisher