Outcomes And Predictors Of Surgical Treatment For Patients With Central Cord Syndrome

Objectives:To evaluate the effectiveness of surgical treatment of central cord syndrome(CCS),and to analyze the factors of affecting postoperative spinal cord function recovery.Methods:Totally 42 patients with CCS who underwent surgical treatment in orthopaedic department of our hospital from 2010 to 2017 were retrospectively analyzed,collecting the patients' age and sex,the interval from injury to surgery,surgical approach,operation time,the amount of blood loss,postoperative complications,the length of high signal in spinal cord,maximum spinal canal stenosis(MCC),maximum compression degree of spinal cord(MSCC),ASIA motor score and JOA score at admission and the final follow-up.According to the interval from injury to surgery,patients were divided into group A(?7 days),group B(8?14 days)and group C(?15 days).The operation time,the amount of blood loss,preoperative and final follow-up JOA score,ASIA motor score,JOA improvement rate and AMS improvement rate of the three groups were compared.The patients were divided into fracture dislocation group and non-fracture dislocation group.The operation time,the amount of blood loss,JOA improvement rate and AMS improvement rate of the two groups were compared.Multivariate analysis was conducted to identify the prognostic factors among the possible influencing factorsResults:Totally 42 patients were included.The average age of 42 patients was 50.52±13.22 years old,range from 26 to 83 years old,mean fellow-up time was 67.0±4.3 months,range from 12 to 107 months,33 males(78.6%)and 9 males(21.4%).37 patients underwent anterior surgery,3 patients underwent posterior surgery and 2 patients underwent anterior and posterior surgery.The JOA score was 10.45±2.57,ASIA motor score was 75.95±16.35,and the final follow-up JOA score was 14.45±1.53 and ASIA motor score was 91.11±5.27,which were significantly higher than that of admission(P<0.05).The improvement rates of JOA and AMS in group A and B were higher than those in group C,with statistical difference.There was no significant difference in JOA improvement rate and AMS improvement rate between group A and group B.There was no significant difference in JOA improvement rate and AMS improvement rate between fracture dislocation group and non-fracture dislocation group.Multivariate analysis showed that long signal length in spinal cord was the main factor for poor prognosis(P<0.05),high energy impairment was the main factor for poor effectiveness of surgical treatment(P<0.05).Conclusions:Surgical treatment of CCS is safe and effective;the effectiveness of surgical treatment two weeks after injury is worse than that within two weeks;the operation effect of non-fracture dislocation CCS patients is obvious,and there is no difference with fracture dislocation group;the long signal length of spinal cord on T2 images indicates that the prognosis of patients with CCS is poor;high energy impairment indicates that the effectiveness of surgical treatment is poor.