title: Traumatic central cord syndrome: neurological and functional outcome at 3 years.
abstract: METHODS
  Retrospective cohort analysis with prospective follow-up.
  
  
  OBJECTIVE
  To evaluate neurological and functional recovery following central cord syndrome.
  
  
  METHODS
  Northern Ireland, population 1.8 million.
  
  
  METHODS
  Twenty-seven cords were identified in 1 year. Five managed conservatively and 22 with surgery. American Spinal Injury Association (ASIA) motor scores (AMS) were calculated to assess neurological recovery. Rotterdam scores assessed functional independence at 3 years.
  
  
  RESULTS
  Average age was 62 years. Mechanism of injury was a fall with neck hyperextension in 81% patients. Average AMS in surgical patients improved from injury, preoperatively, postoperatively, 6 months and 3 years from 51, 81, 83, 90 to 96, respectively. Conservative patients improved from time of injury to day 10 from 57 to 86 and then fell to 84 at 6 months. By 3 years, this had recovered to 91. There was no statistical significant difference in AMS (P=0.15)/change in AMS (ΔAMS) (P=0.92) or percentage of motor deficit resolution (P=0.23) between groups at 3 years. Two patients underwent surgery within 48 h and achieved full motor recovery by 3 years, but this was not significant (P=0.2). ASIA score improvement had a positive correlation with age at injury. Patients treated with surgery had better Rotterdam scores at 3 years than those managed conservatively (P=0.05).
  
  
  CONCLUSIONS
  This study confirms the natural history of central cord syndrome. Although it demonstrates equivocal neurological recovery for both groups, patients treated with surgery regained a greater degree of functional independence.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: Stevenson
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Dargan
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: J
authors.initials: J
authors.lastname: Warnock
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sloan
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: R
authors.initials: R
authors.lastname: Espey
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: S
authors.initials: S
authors.lastname: Maguire
authors.affiliation: Department of Trauma and Orthopaedic Surgery, The Royal Hospitals, Belfast, Northern Ireland, UK.|Spinal Cord Injury Unit, Musgrave Park Hospital, Belfast, UK.
authors.forename: N
authors.initials: N
authors.lastname: Eames
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007494:Ireland; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009422:Nervous System Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D009460:Neurologic Examination; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome