Motor Neurological outcome of Traumatic Central Cord Syndrome

Mohan, K P (2006) Motor Neurological outcome of Traumatic Central Cord Syndrome. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Schneider described an incomplete form of cervical spine injury in the year 1954 in which he stated that there was more involvement of the upper limb than the lower limbs with the affection of the bowel and bladder function . He studied the pattern of injury and the mechanism of injury. FUNCTIONAL OUTCOME: In the study of Penrod [et. al.] only one out of 30 patients was non ambulant while in the >50 years age group 10 out of 17 were non ambulant. All in the younger age group were independent in the eating and the grooming activity while only 71% of the elderly had this status. In study of Martyn et al(11) the functional outcome was that the younger sub set of patients (<50 years) all had ambulatory status and in the 50-70 year age bracket 77% of the patients were ambulant. MATERIALS AND METHODS: This is a study of 25 patients who presented to the Government General Hospital, Chennai with ATCCS, between June 2003 to August 2005. Inclusion Criterion - Patients presenting as traumatic central cord syndrome. Exclusion Criterion - Patients who presented in atypical manner and the recovery pattern follows that of the central cord syndrome. Patients Lost For Follow-Up – 6. Age Incidence: The patient’s age ranged from 18- 80 years. RESULTS: The patients in our study were assessed by the following methods and the conclusions were drawn. The patients were assessed based on the American Spinal Injury Scoring System for the motor assessment of the patients The neurological assessment in the institution was done on a fortnightly basis by a single person. Most of the patients did not have bladder control at the initial review but by the final follow-up majority of the patients had regained the control of bladder. 7 out of 10 conservatively treated and 6 out of the 9 surgically treated patients had bladder control affected at admission. Three patients out of the 19 did not have bladder control at the final follow-up and one patient had developed a periurethral fistula and is now on supra pubic catheter. The two patients who have not regained bladder control are in the age group > 50 years. The patients regained bladder control at a mean of 4.2 months. CONCLUSION: Traumatic central cord syndrome has a significant good motor improvement over time. • Age has a statistically significant adverse effect on the motor neurological outcome. • Canal diameter has no correlation with the neurological outcome. • Surgical treatment showed better improvement in the upper limb recovery but was not statistically significant. • Age has an adverse effect on the bladder function and the patients functional recovery for the ADL.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Motor Neurological outcome ; Traumatic Central Cord Syndrome
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 01:47
Last Modified: 14 Sep 2017 01:47
URI: http://repository-tnmgrmu.ac.in/id/eprint/3072

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