Mechanism of injury and fracture status influence outcomes after central cord injury.

Authors

• Karlo M Pedro
• Mohammed Ali Alvi
• Kathleen Zang
• Christopher Lozano
• Jetan H Badhiwala
• Jefferson R Wilson
• James S Harrop
• James D Guest
• Bizhan Aarabi
• Christopher I Shaffrey
• Michael G Fehlings

Publication/Presentation Date

8-21-2026

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,

Volume

29

Issue

8

First Page

117138

Last Page

117138

ISSN

2589-0042

Published In/Presented At

Pedro, K. M., Alvi, M. A., Zang, K., Lozano, C., Badhiwala, J. H., Wilson, J. R., Harrop, J. S., Guest, J. D., Aarabi, B., Shaffrey, C. I., & Fehlings, M. G. (2026). Mechanism of injury and fracture status influence outcomes after central cord injury. iScience, 29(8), 117138. https://doi.org/10.1016/j.isci.2026.117138

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

42620768

Department(s)

Administration and Leadership

Document Type

Article