Relevance of the diagnosis traumatic cervical Brown-Sequard-plus syndrome: an analysis based on the neurological and functional recovery in a prospective cohort of 148 patients

被引：15
作者：
Pouw, M. H. [1 ]
van de Meent, H. [2 ]
van Middendorp, J. J. [1 ]
Hirschfeld, S. [3 ]
Thietje, R. [3 ]
van Kampen, A. [1 ]
Hosman, A. J. F. [1 ]
机构：
[1] Radboud Univ Nijmegen, Med Ctr, Dept Orthoped Surg, Spine Unit, NL-6500 HB Nijmegen, Netherlands
[2] Radboud Univ Nijmegen, Med Ctr, Dept Rehabil Med, NL-6500 HB Nijmegen, Netherlands
[3] BG Trauma Hosp Hamburg, Spinal Cord Injury Ctr, Hamburg, Germany
来源：
SPINAL CORD | 2010年 / 48卷 / 08期
关键词：
Brown-Sequard-plus syndrome; Brown-Sequard syndrome; functional recovery; neurological recovery; spinal cord injury; SPINAL-CORD-INJURY; INDEPENDENCE MEASURE; INTERNATIONAL STANDARDS; CLASSIFICATION; OUTCOMES; VERSION;
D O I：
10.1038/sc.2009.189
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Study design: Prospective multi-center cohort study. Objectives: To compare the neurological and functional recovery between tetraplegic Brown-Sequard-plus syndrome (BSPS) and incomplete tetraplegia (non-BSPS). Setting: European Multicenter Study of Human Spinal Cord Injury (EM-SCI). Methods: BSPS was defined as a traumatic incomplete spinal cord injury (SCI) with ipsilateral weakness and contralateral loss of pinprick sensation at neurologic levels C2-T1. Acute (0-15 days) and chronic phase (6 or 12 months) were assessed for the American Spinal Injury Association (ASIA) sensory scores, upper extremity motor scores and lower extremity motor scores. Furthermore, chronic phase scores of all Spinal Cord Independence Measure (SCIM) II items were analyzed. Differences in neurological and functional outcome between BSPS patients and non-BSPS patients were calculated using Student's t-tests and Wilcoxon signed rank tests. Results: Out of 148 tetraplegic patients, 30 were diagnosed with BSPS. Patients with an ASIA impairment scale (AIS) B were significantly (P<0.001) more identified in non-BSPS patients (25%) compared with BSPS patients (3%), respectively. After 12 months, the median scores for sphincter management of the bladder for both BSPS and non-BSPS patients were 15. Both 25 and 75% quartile median scores were 15 for BSPS patients and 12 and 15 for non-BSPS patients (P<0.02). Except for the difference in bladder function, no significant differences were identified in other SCIM II subitems and ASIA motor or sensory scores between BSPS and non-BSPS patients when stratified for injury severity by excluding AIS B patients. Conclusion: Compared with incomplete tetraplegic patients, patients with cervical BSPS have a similar neurological and functional recovery when matched for the AIS. Spinal Cord (2010) 48, 614-618; doi:10.1038/sc.2009.189; published online 12 January 2010
引用
收藏
页码：614 / 618
页数：5
相关论文
共 20 条
  • [1] [Anonymous], 2002, INT STAND NEUR CLASS
  • [2] A multicenter international study on the Spinal Cord Independence Measure, version III:: Rasch psychometric validation
    Catz, A.
    Itzkovich, M.
    Tesio, L.
    Biering-Sorensen, F.
    Weeks, C.
    Laramee, M. T.
    Craven, B. C.
    Tonack, M.
    Hitzig, S. L.
    Glaser, E.
    Zeilig, G.
    Aito, S.
    Scivoletto, G.
    Mecci, M.
    Chadwick, R. J.
    El Masry, W. S.
    Osman, A.
    Glass, C. A.
    Silva, P.
    Zeilig, G.
    Aito, S.
    Scivoletto, G.
    Mecci, M.
    Chadwick, R. J.
    El Masry, W. S.
    Osman, A.
    Glass, C. A.
    Silva, P.
    Soni, B. M.
    Gardner, B. P.
    Savic, G.
    Bergstrom, E. M.
    Bluvshtein, V.
    Ronen, J.
    [J]. SPINAL CORD, 2007, 45 (04) : 275 - 291
  • [3] Catz A, 2001, DISABIL REHABIL, V23, P263
  • [4] Epstein B E, 1999, Am J Orthop (Belle Mead NJ), V28, P650
  • [5] Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials
    Fawcett, J. W.
    Curt, A.
    Steeves, J. D.
    Coleman, W. P.
    Tuszynski, M. H.
    Lammertse, D.
    Bartlett, P. F.
    Blight, A. R.
    Dietz, V.
    Ditunno, J.
    Dobkin, B. H.
    Havton, L. A.
    Ellaway, P. H.
    Fehlings, M. G.
    Privat, A.
    Grossman, R.
    Guest, J. D.
    Kleitman, N.
    Nakamura, M.
    Gaviria, M.
    Short, D.
    [J]. SPINAL CORD, 2007, 45 (03) : 190 - 205
  • [6] Brown-Sequard syndrome
    Firlik, AD
    Welch, WC
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (04) : 285 - 285
  • [7] Brown-Sequard syndrome associated with Horner's syndrome after a penetrating trauma at the cervicomedullary junction
    García-Manzanares, MD
    Belda-Sanchis, JI
    Giner-Pascual, M
    Miguel-Leol, I
    Delgado-Calvo, M
    Sanz, JLAY
    [J]. SPINAL CORD, 2000, 38 (11) : 705 - 707
  • [8] Classifying incomplete spinal cord injury syndromes: Algorithms based on the international standards for neurological and functional classification of spinal cord injury patients
    Hayes, KC
    Hsieh, JTC
    Wolfe, DL
    Potter, PJ
    Delaney, GA
    [J]. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2000, 81 (05): : 644 - 652
  • [9] Henderson S O, 1998, J Emerg Med, V16, P847, DOI 10.1016/S0736-4679(98)00096-1
  • [10] Rasch analysis of the Catz-Itzkovich spinal cord independence measure
    Itzkovich, M
    Tripolski, M
    Zeilig, G
    Ring, H
    Rosentul, N
    Ronen, J
    Spasser, R
    Gepstein, R
    Catz, A
    [J]. SPINAL CORD, 2002, 40 (08) : 396 - 407
12