Document Detail

Diagnostic criteria of traumatic central cord syndrome. Part 1: a systematic review of clinical descriptors and scores.
MedLine Citation:
PMID:  20048754     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Systematic review.
BACKGROUND: The applied definition of traumatic central cord syndrome (TCCS) lacks specific quantified diagnostic criteria.
OBJECTIVE: To review currently applied TCCS diagnostic criteria and quantitative data regarding the 'disproportionate weakness' between the upper and lower extremities described in original studies reporting on TCCS subjects.
METHODS: A MEDLINE (1966 to 2008) literature search was conducted. The descriptors applied to define TCCS were extracted from all included articles. We included original studies that reported on the differences in motor score (based on the Medical Research Council scale) between the total upper extremity motor score (UEMS) and the total lower extremity motor score (LEMS), in a minimum of five TCCS patients at the time of hospital admission. The mean difference between the total UEMS and the total LEMS of the patients included in each study was calculated. Case reports were excluded.
RESULTS: None of the identified studies on TCCS patients reported inclusion and/or exclusion criteria using a quantified difference between the UEMS and LEMS. Out of 30 retrieved studies, we identified seven different clinical descriptors that have been applied as TCCS diagnostic criteria. Nine studies reporting on a total of 312 TCCS patients were eligible for analysis. The mean total UEMS was 10.5 motor points lower than the mean total LEMS.
CONCLUSIONS: There is no consensus on the diagnostic criteria for TCCS. Nevertheless, this review revealed an average of 10 motor points between the UEMS and LEMS as a possible TCCS diagnostic criterion. However, further discussion by an expert panel will be required to establish definitive diagnostic criteria.
M H Pouw; J J van Middendorp; A van Kampen; S Hirschfeld; R P H Veth; ; A Curt; A J F Hosman; H van de Meent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-01-05
Journal Detail:
Title:  Spinal cord     Volume:  48     ISSN:  1476-5624     ISO Abbreviation:  Spinal Cord     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-05-31     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  652-6     Citation Subset:  IM    
Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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MeSH Terms
Arm / innervation,  physiopathology
Central Cord Syndrome / complications,  diagnosis*,  physiopathology*
Diagnosis, Differential
Disability Evaluation*
Extremities / innervation,  physiopathology*
Leg / innervation,  physiopathology
Muscle Weakness / diagnosis,  etiology,  physiopathology
Paralysis / diagnosis*,  etiology,  physiopathology*

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