Multi-dimensional efficacy evaluation of comprehensive rehabilitation in patients with traumatic central cord syndrome

English Keywords:Spinal cord injury  Central cord syndrome  Rehabilitation treatment  Efficacy evaluation

English Abstract:

  【Abstract】 Objectives: To observe the improvements on neurological function and quality of life in traumatic central cord syndrome(TCCS) patients following comprehensive rehabilitation therapy, and to evaluate the effects from multi-dimension. Methods: A retrospective analysis was performed on 90 TCCS patients admitted and treated in our hospital from January 2016 to December 2021. There were 74 males and 16 females, aged 27 to 85 years(56.6±10.7 years). The patients were divided into postoperative rehabilitation group(82 cases) and simple rehabilitation group(8 cases) according to whether they had received cervical surgery before comprehensive rehabilitation therapy. There were no significant differences in age, gender and grade of spinal cord injury between the two groups(P>0.05). All the patients received comprehensive rehabilitation therapy such as physical therapy, occupational therapy(OT), and bladder management for 1 to 3 months. ASIA impairment scale(AIS) according to the American Spinal Injury Association: International Standards for Neurological Classification of Spinal Cord Injury(ISNCSCI), motor score(MS) as well as International Functional Classification Rehabilitation Combination(ICF-RS) scores were assessed and compared between the two groups. The changes of bladder function and the occurrence of complications were counted to comprehensively evaluate the recovery of neurological function in TCCS patients and judge the efficacy of the rehabilitation measures from multi-dimension. Results: Before rehabilitation therapy, 48 patients were of AIS grade C and 42 were of grade D. After comprehensive rehabilitation therapy, of all the patients, 27 patients(23 in the postoperative rehabilitation group and 4 in the simple rehabilitation group) of AIS grade C improved to grade D, and the AIS grades of other patients remained unchanged, while their MSs of lower limb and upper limb at discharge were significantly higher than those before rehabilitation therapy(P<0.05). There was no significant difference between groups in MS(P>0.05). Among the items of ICF-RS, the scores of all items but "b280 Sensation of pain, d240 Handling stress and other psychological demands" after rehabilitation improved than before rehabilitation with statistical differences(P<0.05). There was no significant difference in ICF-RS scores between groups(P>0.05). A total of 33 patients recovered from catheterization to spontaneous urination. The top two complications of spinal cord injury were spasm(54.4%) and neuralgia(23.3%). There was no significant correlation between the occurrence of spasm and the degree of MS recovery(P=0.06). Conclusions: Comprehensive rehabilitation therapy can significantly promote the recovery of neurological function in TCCS patients, and the comprehensive functions of both postoperative rehabilitation and simple rehabilitation TCCS patients can be significantly improved. ICF-RS with detailed items is suitable for the evaluation of the spinal cord injury in TCCS.