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Comparative Study
. 2007;30(3):215-24.
doi: 10.1080/10790268.2007.11753929.

Incidence and outcomes of spinal cord injury clinical syndromes

William McKinley  1 , Katia Santos, Michelle Meade, Karen Brooke
Affiliations
Comparative Study

Incidence and outcomes of spinal cord injury clinical syndromes

William McKinley et al. J Spinal Cord Med. 2007.

Abstract

Background/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).

Design: Retrospective review.

Setting: Tertiary care, level 1 trauma center inpatient rehabilitation unit.

Participants: Eight hundred thirty-nine consecutive admissions with acute SCIs.

Main outcomes measures: 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.

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Figures

Figure 1
Figure 1. Incidence of SCI clinical syndromes (n = 839).
See this image and copyright information in PMC

References

    1. National Spinal Cord Injury Statistical Center . Spinal Cord Injury: Facts and Figures at a Glance. Birmingham, AL: National Spinal Cord Injury Statistical Center; 2005.
    1. American Spinal Injury Association . Standards for Neurological and Functional Classification of Spinal Cord Injury. Chicago, IL: American Spinal Injury Association; 1992.
    1. Burns SP, Golding DG, Rolle WA, et al. Recovery of ambulation in motor incomplete tetraplegia. Arch Phys Med Rehabil. 1997;78:1169–1172. - PubMed
    1. Brown-Sequard CE. Lectures on the physiology and pathology of the central nervous system and the treatment of organic nervous affections. Lancet. 1868;2:593–595. 659–662, 755–757, 821–823.
    1. Bohlman HH. Acute fractures and dislocations of the cervical spine: an analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979;61:1119–1142. - PubMed

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