Mechanism of injury and fracture status influence outcomes after central cord injury
Date
2026-08-21
Journal Title
Journal ISSN
Volume Title
Citation Stats
Attention Stats
Abstract
Central cord syndrome (CCS) is the most common form of incomplete cervical spinal cord injury (SCI), yet its optimal management remains controversial. We examined whether stratifying CCS by injury stability improves treatment assessment. CCS was defined as an American Spinal Injury Association Impairment Scale (AIS) C/D cervical SCI with a ≥5-point lower-upper extremity motor score difference and classified as CCS-stable (CCS-S) or -unstable (CCS-U) based on the absence or presence of fracture/dislocation. Functional recovery at 1 year was assessed using the functional independence measure (FIM) motor score. Among 291 patients, 131 (45%) had CCS-S. These patients were older and more frequently sustained fall-related injuries. In the propensity score-matched cohort, CCS-S showed greater functional improvement than CCS-U, although the difference was attenuated after multiplicity adjustment (mean difference 5.46 points, p = 0.24). Surgery was associated with higher odds of achieving the FIM motor minimum clinically important difference (MCID) in CCS-S (odds ratio [OR] = 2.85), supporting CCS-S as a distinct incomplete SCI phenotype with a more favorable postoperative recovery.
Type
Department
Description
Provenance
Subjects
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Pedro, KM, MA Alvi, K Zang, C Lozano, JH Badhiwala, JR Wilson, JS Harrop, JD Guest, et al. (2026). Mechanism of injury and fracture status influence outcomes after central cord injury. Iscience, 29(8). pp. 117138–117138. 10.1016/j.isci.2026.117138 Retrieved from https://hdl.handle.net/10161/35545.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke
Christopher Ignatius Shaffrey
I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.