title: 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.
abstract: METHODS
  Prospective multicenter cohort study.
  
  
  OBJECTIVE
  To compare the neurological recovery and functional outcomes between traumatic central cord syndrome (TCCS) patients and motor incomplete tetraplegic patients.
  
  
  METHODS
  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 (UEMSLEMS), (2) intermediate-TCCS group (UEMS=(1-9 points)<LEMS) and (3) TCCS group (UEMS=(10 points)<LEMS). Student's t-tests and χ(2)-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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Spine Unit, Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Martinpouw@yahoo.com
authors.forename: M H
authors.initials: MH
authors.lastname: Pouw
authors.forename: J J
authors.initials: JJ
authors.lastname: van Middendorp
authors.forename: A
authors.initials: A
authors.lastname: van Kampen
authors.forename: A
authors.initials: A
authors.lastname: Curt
authors.forename: H
authors.initials: H
authors.lastname: van de Meent
authors.forename: A J F
authors.initials: AJ
authors.lastname: Hosman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020210:Central Cord Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004525:Efferent Pathways / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011782:Quadriplegia / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult