Incidence and outcomes of spinal cord injury clinical syndromes.
OBJECTIVE
To examine and compare demographics and functional outcomes for individuals with spinal cord injury (SCI) clinical syndromes, including central cord (CCS), Brown-Sequard (BSS), anterior cord (ACS), posterior cord (PCS), cauda equina (CES), and conus medullaris (CMS).


METHODS
Retrospective review.


METHODS
Tertiary care, level 1 trauma center inpatient rehabilitation unit.


METHODS
Eight hundred thirty-nine consecutive admissions with acute SCIs.


METHODS
Functional independence measure (FIM), FIM subgroups (motor, self-care, sphincter control), length of stay (LOS), and discharge disposition.


RESULTS
One hundred seventy-five patients (20.9%) were diagnosed with SCI clinical syndromes. CCS was the most common (44.0%), followed by CES (25.1%) and BSS (17.1%). Significant differences (P < or = 0.01) were found between groups with regard to age, race, etiology, total admission FIM, motor admission FIM, self-care admission and discharge FIM, and LOS. Statistical analysis between tetraplegic BSS and CCS revealed significant differences (P < or = 0.01) with respect to age (39.7 vs 53.2 years) and a trend toward significance (P < or = 0.05) with regard to self-care admission and discharge FIM. No significant differences (P < or = 0.01) were found when comparing CMS to CES.


CONCLUSIONS
SCI clinical syndromes represent a significant proportion of admissions to acute SCI rehabilitation, with CCS presenting most commonly and representing the oldest age group with the lowest admission functional level of all SCI clinical syndromes. Patients with cervical BSS seem to achieve higher functional improvement by discharge compared with patients with CCS. Patients with CMS and CES exhibit similar functional outcomes. Patients with ACS and PCS show functional gains with inpatient rehabilitation, with patients with ACS displaying the longest LOS of the SCI clinical syndromes. These findings have important implications for the overall management and outcome of patients with SCI.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA. wmckinle@hsc.vcu.edu
William
W
McKinley
Katia
K
Santos
Michelle
M
Meade
Karen
K
Brooke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018437:Brown-Sequard Syndrome / Q000453:epidemiology / Q000534:rehabilitation*; D020210:Central Cord Syndrome / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011128:Polyradiculopathy / Q000453:epidemiology / Q000534:rehabilitation*; D020127:Recovery of Function; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000453:epidemiology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation; D016896:Treatment Outcome