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.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Justin B
JB
Hohl
Joon Y
JY
Lee
John A
JA
Horton
Jeffrey A
JA
Rihn
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