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Published in: European Spine Journal 1/2015

01-01-2015 | Original Article

Hyperextension injury of the cervical spine with central cord syndrome

Authors: Crispin Thompson, José Filipe Gonsalves, David Welsh

Published in: European Spine Journal | Issue 1/2015

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Abstract

Purpose

Traumatic central cord syndrome (TCCS) is the most commonly encountered type of incomplete spinal cord injury. TCCS typically occurs in patients over the age of 50 with a narrow spinal canal and follows an acute hyperextension injury of the cervical spine. Here, we report on the demographics of TCCS patients, their clinical course and outcomes, and the factors that may have influenced these outcomes.

Methods

We conducted a retrospective folder review of patients who presented to our facility between January 2004 and December 2008 following hyperextension injury of the cervical spine and with the clinical manifestations of a central cord syndrome. Patient details were obtained from the acute spinal cord injury register at Groote Schuur Hospital and the patient folders, radiographs and magnetic resonance imaging films were reviewed. Predetermined data points were identified, tabulated and analysed, with only information from the injury-related admission being included.

Results

An ASIA motor score of ≥60 on admission or discharge correlated with an 80 % chance of being able to walk at discharge from hospital. An ASIA motor score of ≤50 on admission correlated with an 80 % chance of not walking at discharge. An ASIA motor score of ≤50 at discharge meant a patient was not only unable to walk, but required placement in a spinal injury rehabilitation centre. Further, if a patient had a cervical spinal canal diameter of ≥8 mm they had a 50 % chance of clinical improvement and nearly 80 % chance of a functional outcome.

Conclusion

The Groote Schuur Hospital patient population differs from the international norm, particularly with respect to age and mechanism of injury. The ASIA motor score and cervical spine canal diameter proved to be useful predictors of outcome. Within our patient group, timing of surgery did not appear to influence the outcome.
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Metadata
Title
Hyperextension injury of the cervical spine with central cord syndrome
Authors
Crispin Thompson
José Filipe Gonsalves
David Welsh
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3432-6

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