Diagnostic criteria of traumatic central cord syndrome. Part 2: a questionnaire survey among spine specialists

Spinal Cord. 2010 Sep;48(9):657-63. doi: 10.1038/sc.2010.72. Epub 2010 Jun 29.


Study design: A questionnaire survey.

Objectives: To evaluate the need for the introduction of quantitative diagnostic criteria for the traumatic central cord syndrome (TCCS).

Setting: An online questionnaire survey with participants from all over the world.

Methods: An invitation to participate in an eight-item online survey questionnaire was sent to surgeon members of AOSpine International.

Results: Out of 3340 invited professionals, 157 surgeons (5%) from 41 countries completed the survey. Whereas most of the respondents (75%) described greater impairment of the upper extremities than of the lower extremities in their own TCCS definitions, symptoms such as sensory deficit (39%) and bladder dysfunctions (24%) were reported less frequently. Initially, any difference in motor strength between the upper and lower extremities was considered most frequently (23%) as a 'disproportionate' difference in power. However, after presenting literature review findings, the majority of surgeons (61%) considered a proposed difference of at least 10 points of power (based on the Medical Research Council scale) in favor of the lower extremities as an acceptable cutoff criterion for a diagnosis of TCCS. Most of the participants (40%) felt that applying a single criterion to the diagnosis of TCCS is insufficient for research purposes.

Conclusion: Various definitions of TCCS were used by physicians involved in the spinal trauma care. The authors consider a difference of at least 10 motor score points between upper and lower extremity power a clear diagnostic criterion. For clinical research purposes, this diagnostic criterion can be considered as a face valid addendum to the commonly applied TCCS definition as introduced by Schneider et al.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Central Cord Syndrome / complications
  • Central Cord Syndrome / diagnosis*
  • Central Cord Syndrome / physiopathology
  • Data Collection / standards*
  • Diagnosis, Differential
  • Disability Evaluation*
  • Humans
  • Muscle Weakness / diagnosis*
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology
  • Paralysis / diagnosis*
  • Paralysis / etiology
  • Paralysis / physiopathology
  • Surveys and Questionnaires / standards*