This article is more than 5 years old. Information may no longer be current.
Early treatment of central cord syndrome still controversial
Click Here to Manage Email Alerts
A database study of patients who underwent either delayed or early treatment for central cord syndrome showed little, if any, benefits of early treatment.
The study included 68 patients who presented to a regional spinal cord injury center between January 2004 and June 2009 with central cord syndrome and underwent surgical decompression. Nineteen patients underwent surgery within a day of presentation, and the remaining 49 patients underwent surgery on a delayed basis. The mean age, sex, percentage of patients with cervical fracture and cord edema were similar between the groups. There were no differences between the surgical procedures in either group, according to the researchers.
The researchers used changes in the American Spinal Injury Association motor score (AMS) in the first week after surgery to detect any possible advantages to early surgery. The change in AMS after the first 7 days between the early group (-2.9 points) and the delayed group (-4.2 points) was not significant. Also, the number of patients who exhibited early improvement in the early surgery group (50%) was similar to that in the delayed group (48%).
Using multiple linear regression and correlation analysis, the researchers found the only predictor of AMS change was age, and it had a negative effect.
“Early treatment of patients with CCS remains controversial,” the researchers wrote. “Although some long-term neurological recovery is expected in patients with a CCS, surgeons and patients should not expect early neurological improvement with or without early operative intervention.” – by Robert Linnehan
Disclosures: Kepler reports that he is a board member or committee appointee for the Association of Collaborative Spine Research, is a consultant for Healthgrades Inc. and receives support from CSRS and NASS for non-study-related clinical or research efforts. Please see the full study for a list of all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts