A novel classification system for traumatic central cord syndrome: the central cord injury scale (CCIS).
METHODS
Retrospective study of 37 patients with traumatic central cord syndrome.


OBJECTIVE
The purpose of this study is to review a series of patients with central cord syndrome and to introduce a classification system that is predictive of functional outcome.


BACKGROUND
Central cord syndrome is the most common incomplete spinal cord injury, yet a predictive classification system does not exist.


METHODS
Thirty-seven patients with traumatic central cord syndrome had 1-year results of the motor portion of the Functional Independence Measurement (FIM) Score. Ten factors were analyzed for their predictive effect on the 1-year Motor FIM Score.


RESULTS
There were 8 women and 29 men with a mean age of 55.1 years. The mean injury motor FIM was 21.9 and mean 1-year Motor FIM: 70.2 (P < 0.001). The following had a predictive effect on 1-year Motor FIM: Injury ASIA Motor Score (P < 0.013) and magnetic resonance imaging evidence of abnormal signal intensity (P < 0.007). Points were assigned to these factors, and patients were categorized as Central Cord Injury Scale (CCIS) 1, 2, or 3. CCIS 1: n = 6, mean 1-year Motor FIM = 40.8; CCIS 2: n = 19 and FIM = 72.4; and CCIS 3: n = 12 and FIM = 81.5. Each classification had an increasing percentage of patients who could walk without ever using a wheelchair and had independence in bladder and bowel function.


CONCLUSIONS
The CCIS is predictive of a patient's functional outcome at 1 year and has the potential to help patients and physicians establish realistic expectations for functional recovery based on ASIA Motor Score and magnetic resonance imaging findings.
Hohl
Justin B
JB
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Lee
Joon Y
JY
Horton
John A
JA
Rihn
Jeffrey A
JA
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020210:Central Cord Syndrome / Q000145:classification* / Q000534:rehabilitation / Q000601:surgery; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome