Traumatic central cord syndrome: clinical features and functional outcomes.

This retrospective study examined clinical features of 81 rehabilitated patients with traumatic central cord syndrome and identified factors which predicted more favorable rehabilitation outcomes. The sample had two age peaks and a mean age of 46 years. Most injuries were caused by vehicular accidents, but falls were more common among older persons. Predominant upper extremity weakness was proximal in 4%, distal in 36%, and generalized in the remainder. Forty-one percent also had significant lower limb weakness. More than 90% of the patients experienced neurologic recovery of upper and/or lower limb strength. After an average acute hospitalization of 30 days and a mean rehabilitation stay of 70 days, most patients performed each of 14 functional skills independently, 84% had bladder continence, and 89% were discharged home. Statistically significant improvements were noted for mean Modified Barthel Index scores between rehabilitation admission and discharge. Favorable rehabilitation outcomes were associated most frequently with younger age, preinjury employment, absence of lower extremity impairment on admission, and documented upper or lower extremity strength recovery during rehabilitation. Central cord syndrome generally has a good prognosis for neurologic and functional improvement during rehabilitation.