Document Type

Article

Publication Date

8-21-2026

Comments

This article is the author's final published version in iScience, Volume 29, Issue 8, 2026, Article number 117138.

The published version is available at https://doi.org/10.1016/j.isci.2026.117138. Copyright © 2026 The Author(s).

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, p = 0.24). Surgery was associated with higher odds of achieving the FIM motor minimum clinically important difference (MCID) in CCS-S (odds ratio [OR] = 2.85), supporting CCS-S as a distinct incomplete SCI phenotype with a more favorable postoperative recovery.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

42620768

Language

English

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