Journal of Spinal Cord Medicine最新文献

{"title":"Strategies to mitigate muscle mass loss in individuals with spinal cord injury.","authors":"Astrid M H Horstman, Janneke M Stolwijk-Swüste, Luc J C van Loon, Sonja de Groot","doi":"10.1080/10790268.2025.2503048","DOIUrl":"10.1080/10790268.2025.2503048","url":null,"abstract":"<p><strong>Context: </strong>Muscle atrophy following spinal cord injury (SCI) is severe, often exceeding rates observed in disuse or critical illness. Neurogenic factors, such as the loss of neural input and disruption of neuromuscular signaling worsen the effects of physical inactivity. The severe muscle loss lowers muscle quality and impairs function, increasing the risk of chronic metabolic diseases. Understanding the mechanisms underlying SCI-induced muscle atrophy is crucial for developing targeted interventions.</p><p><strong>Objective: </strong>This review examines SCI-induced muscle atrophy mechanisms, addresses limitations of current interventions, and proposes therapeutic strategies integrating exercise mimetics, nutrition, and pharmacological agents to overcome anabolic resistance and improve muscle preservation.</p><p><strong>Methods: </strong>A PubMed search was conducted using terms including \"spinal cord injury\", \"disuse\", \"muscle atrophy\", \"anabolic resistance\", \"muscle protein metabolism\" and \"interventions\". (Pre)clinical studies and reviews relevant to skeletal muscle physiology after SCI were included.</p><p><strong>Results: </strong>Anabolic resistance seems to be a key contributor to rapid SCI-induced muscle loss. Motor-complete SCI prevents voluntary contractions, limiting traditional exercise-based interventions. Neuromuscular electrical stimulation (NMES) can mitigate muscle atrophy during immobilization and critical illness especially when combined with protein supplementation. Additional nutritional interventions, including vitamin D, creatine, ursolic acid, polyunsaturated fatty acids (PUFAs), and pharmacological agents such as androgens, myostatin inhibitors, and β2-adrenoceptor agonists, may further attenuate muscle atrophy.</p><p><strong>Conclusion: </strong>A multidimensional approach integrating NMES, targeted nutrition, and pharmacological strategies may enhance muscle mass retention, metabolic health, and rehabilitation outcomes in individuals with SCI. Further research is needed to refine these interventions and establish clinical guidelines for muscle preservation in this population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1013-1031"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid expansion of a spinal anastomosing hemangioma during pregnancy with acute paralysis: A case report.","authors":"Ting-Wei Chang, Yu-Tse Liu","doi":"10.1080/10790268.2025.2542019","DOIUrl":"10.1080/10790268.2025.2542019","url":null,"abstract":"<p><strong>Context: </strong>Anastomosing hemangioma typically presents as an asymptomatic lesion in the genitourinary tract, but can cause abdominal pain and hematuria. Early identification and surgical removal are crucial to avoid poor outcomes.</p><p><strong>Case report: </strong>We report a case of acute paralysis due to rapid tumor enlargement during pregnancy. This case is unique as anastomosing hemangiomas rarely occur in the spinal region, and cases where they cause such severe symptoms have rarely been reported, particularly in pregnant women.</p><p><strong>Conclusion: </strong>This case highlights the critical need for early recognition and intervention in anastomosing hemangiomas, particularly when rapid growth can lead to severe complications such as paralysis. The rare presentation during pregnancy highlights the importance of considering anastomosing hemangioma in the differential diagnosis. Further, this case highlights that timely surgical intervention is essential to prevent catastrophic outcomes and to improve patient prognosis.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1176-1180"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability assessment of power wheelchairs.","authors":"Anand Mhatre, Carmen DiGiovine, Colin Mair","doi":"10.1080/10790268.2025.2542020","DOIUrl":"10.1080/10790268.2025.2542020","url":null,"abstract":"<p><strong>Objective: </strong>To develop and assess new reliability performance measures for wheelchair devices using reliability engineering methods and compare them across wheelchair models.</p><p><strong>Design, setting and participants: </strong>This retrospective study analyzes wheelchair repair data from n = 1092 power wheelchairs prescribed by the National Health Service (NHS) through the West of Scotland Mobility and Rehabilitation Centre (WestMARC) between December 2007 and October 2013 in Greater Glasgow, Scotland, UK. This dataset was received by The Ohio State University in 2022, and repairable systems reliability analysis was performed.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measures: </strong>Reliability performance measures derived from the reliability engineering modeling of the mean cumulative number of repairs included Repair Trend, Mean Time Between Failures (MTBF), and a Wheelchair Reliability Index (WRI). It was hypothesized that there are no differences in the repair distributions between standard and complex wheelchair seating models in the dataset, and repair distributions of models stratified by age into two groups: adults and seniors. Additionally, the relationships between recurrent repair events and demographics were tested.Results: Four wheelchair models were analyzed: two standard (S1, S2) and two complex (C1, C2) seating models. Models S2 and C2 demonstrated a linear repair trend, while the other two had an exponential one. Consistent with previous evidence, the complex seating models had significantly different repair distribution and lower reliability compared to standard seating models, <i>p</i> <i><</i> <i>.05</i>. About 68-80% of units failed among the models and had an MTBF ranging from 4-8 months over five years. Model C1, which is used outdoors actively, is twice as costly but has one-fourth the WRI compared to standard seating models. There is a significant difference among repair distributions of adults and seniors, <i>p</i> <i><</i> <i>.05</i>. No significant associations were found between recurrent repair events and demographic variables of age and sex.</p><p><strong>Conclusion: </strong>This is the first study, to the authors' knowledge, that modeled wheelchair field failure data to develop reliability performance measures and compare the reliability of standard and complex seating power wheelchair models. The study found a lower overall MTBF value, indicating that all study wheelchairs demonstrate poor reliability and require condition inspections every 3-6 months. Individuals requiring the highest level of care utilize complex seating wheelchair models and deserve enhanced wheelchair reliability and safety. Our study findings underscore the urgent need for reliability performance monitoring and subsequent improvements in the areas of wheelchair selection, standards, servicing innovation, and provision systems.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"941-951"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The time-dependent efficacy of early surgical decompression in patients with traumatic spinal cord injury: A systematic review and meta-analysis.","authors":"Xiaolong Li, Yuan Yuan, Yilin Chen, JinYe Lv, Yihao Lian, Heng Yin","doi":"10.1080/10790268.2025.2517925","DOIUrl":"10.1080/10790268.2025.2517925","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies have demonstrated that early surgical intervention in patients with traumatic spinal cord injury leads to superior recovery of various indicators, including neurological function, compared to late surgical intervention. However, some relevant clinical randomized controlled trials have indicated that the motor function recovery of patients undergoing early surgical decompression does not show a significant advantage during initial follow-up periods. The benefits of early surgical decompression become more apparent as the follow-up duration extends. Therefore, this study aims to evaluate the prognosis of early versus late surgical intervention on traumatic spinal cord injury and to analyze whether the prognostic benefits of early surgical decompression in traumatic spinal cord injury patients are time-dependent.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis by searching the PubMed, Embase, and Cochrane Library databases for randomized controlled trials and quasi-randomized controlled trials that addressed the timing of surgical intervention for traumatic spinal cord injury. The data extracted from all included studies were processed and analyzed utilizing the RevMan 5.4 software.</p><p><strong>Results: </strong>Eight studies involving 702 patients were included in this analysis, with 345 patients in the early surgery group and 357 patients in the late surgery group. The results showed that the early surgery group had a significantly higher rate of improvement in AIS grade (OR = 1.50; 95% CI: 1.05-2.15; <i>p</i> = 0.03) and a shorter hospital stay (MD = -4.76; 95% CI: -9.19 - -0.32; <i>p</i> = 0.04) compared to the late surgery group. Although there was no significant difference in total motor scores between the two groups in the early postoperative period, the pooled data still favored the early surgery group (MD = 4.43; 95% CI: 1.23-7.63; <i>p</i> = 0.007). There was no significant difference in postoperative complications between the two groups (RR = 0.61; 95% CI: 0.30-1.22; <i>p</i> = 0.16).</p><p><strong>Conclusion: </strong>Early surgical decompression leads to better prognosis in patients with traumatic spinal cord injury and shows a trend of more obvious advantages in motor function recovery with longer follow-up time than late surgical intervention.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1054-1063"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of risk factors for pulmonary infection in patients with cervical spinal cord injury.","authors":"Yichen Gong, Ning Li","doi":"10.1080/10790268.2025.2588899","DOIUrl":"10.1080/10790268.2025.2588899","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a meta-analysis of the literature to summarize the risk factors for pulmonary infection in patients with cervical spinal cord injury.</p><p><strong>Methods: </strong>Computer-based searches were performed in CNKI, CBM, Wanfang Database, VIP Series Databases, The Cochrane Library, WOS, PubMed, Springer Link, EBSCO, MEDLINE and other databases. The time frame was from January 1, 2000 to April 1, 2025. Case-control studies and cohort studies related publications were searched according to subject terms and free words. According to inclusion and exclusion criteria, 7 publications were identified, and finally meta-analysis was performed on them by Review Manager 5.3 software.</p><p><strong>Results: </strong>Seven publications met the inclusion criteria, with a total of 912 cases and 742 controls. The results of meta-analysis showed that the risk factors for pulmonary infection in patients with cervical spinal cord injury were: American Spinal Injury Association (ASIA) Impairment Scale (AIS) - AIS A and AIS B (OR: 3.90, 95% CI: 2.74-5.53), high-level injury (OR: 2.73, 95% CI: 1.69-4.40), hormone shock therapy (OR: 4.14, 95% CI: 2.58-6.62), smoking history (OR = 2.34, 95% CI: 1.54-3.55), operation time (P < 0.00001, <i>I</i>² = 96%), hypoalbuminemia (P < 0.00001, <i>I</i>² = 96%), and age (P < 0.00001, <i>I</i>² = 95%).</p><p><strong>Conclusion: </strong>AIS A and B, high-level injury, hormone shock therapy and smoking history are risk factors for pulmonary infection in patients with cervical spinal cord injury. Controlling the above factors can effectively reduce the incidence of pulmonary infection in patients with cervical spinal cord injury.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1152-1159"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailored transcutaneous electrical nerve stimulation improves dysesthesia in individuals with spinal cord injury: A randomized N-of-1 trial.","authors":"Yuki Nishi, Koki Ikuno, Yuji Minamikawa, Michihiro Osumi, Shu Morioka","doi":"10.1080/10790268.2025.2517929","DOIUrl":"10.1080/10790268.2025.2517929","url":null,"abstract":"<p><strong>Context: </strong>Current therapeutic interventions are often ineffective for dysesthesia, including tingling and allodynia, caused by spinal cord injury (SCI). Dysesthesia-matched TENS (DM-TENS) is an innovative approach for dysesthesias that customizes stimulation parameters to align with an individual's specific dysesthesia characteristics.</p><p><strong>Objective: </strong>We aimed to evaluate the efficacy of DM-TENS for dysesthesia in individuals with SCI.</p><p><strong>Design: </strong>A randomized, placebo-controlled, aggregated N-of-1 trial was conducted in six individuals with SCI.</p><p><strong>Methods: </strong>Participants received either DM-TENS as an intervention or sham TENS as a control. Each treatment was administered for 60 min/day over a 7-day period. The outcome measures included the Numeric Rating Scale (NRS) for dysesthesia and Short-Form McGill Pain Questionnaire-2 (SF-MPQ2).</p><p><strong>Results: </strong>Using a hierarchical Bayesian model, we found that dysesthesia-matched TENS provided clinically meaningful improvements in dysesthesia among individuals with SCI, with a high posterior probability (96-100%) exceeding the minimal clinically meaningful difference (NRS of 2.70) at both the individual and population levels. The mean NRS was 5.79 (95% credible interval [95% CI]: 4.58-7.01) during the placebo period, and 1.12 (95% CI: 0.59-1.66) during the DM-TENS period. In the SF-MPQ-2, the dysesthesia-matched TENS effects showed decisive evidence (BF₁₀ > 1000) for items on tender, pain caused by light touch, tingling or pins and needles, and numbness.</p><p><strong>Conclusions: </strong>This series of N-of-1 trials comparing dysesthesia-matched TENS with placebo indicated a reduction in dysesthesia in individuals with SCI. Thus, dysesthesia-matched TENS is a promising therapeutic option for managing dysesthesia in this population.<b>Trial registration:</b> UMIN Japan identifier: UMIN000050250..</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1064-1073"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing prognostic accuracy for walking recovery after spinal cord injury: The 2026 Ernest Bors, MD Award for Scientific Development.","authors":"Carol Ann Murphy, Florian P Thomas","doi":"10.1080/10790268.2026.2689286","DOIUrl":"https://doi.org/10.1080/10790268.2026.2689286","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":"49 5","pages":"851-852"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness in spinal cord injury: A systematic review and comparison with the general population.","authors":"Louisa M C O'Donnell, Diana S Dorstyn, Linda Barclay","doi":"10.1080/10790268.2025.2593074","DOIUrl":"10.1080/10790268.2025.2593074","url":null,"abstract":"<p><strong>Context: </strong>The psychosocial consequences of a Spinal Cord Injury or Disorder (SCI/D) can include increased loneliness. However, differences in the measurement of loneliness confound the available evidence.</p><p><strong>Objectives: </strong>To compare levels of loneliness between adults with a SCI/D and the general population (Touch Test data) using the UCLA Loneliness Scale (any version). A secondary aim was to explore potential subgroups vulnerable to loneliness.</p><p><strong>Methods: </strong>Observational studies examining loneliness in SCI/D were identified via CINAHL, PubMed, PsycINFO, MEDLINE, Embase, Web of Science (up until 9th Sept 2025), Google Scholar (first 100 results), and targeted citation searching. Standardized mean group differences (Hedges' <i>g</i>) were pooled using random effects modelling and the methodological quality of included studies evaluated (QualSyst tool). Study characteristics and bivariate correlations of loneliness in SCI/D were additionally examined.</p><p><strong>Results: </strong>Thirteen observational studies (<i>N</i> = 3029 adults with SCI/D) were included in the analysis. Average UCLA scores (revised Version 3, 20-item and 3-item) for the pooled SCI/D sample and the general population were comparable, with both groups reporting moderate levels of loneliness (<i>g</i>_w = .01; CI: -.43 to .46, <i>P</i> = .951). Individual effect estimates among the SCI/D studies were, however, characterized by imprecision and heterogeneity. Associations between loneliness, demographic and SCI/D characteristics were inconsistent although those who were lonely did report adverse health and social outcomes.</p><p><strong>Conclusions: </strong>The underlying personal, social and environmental factors which contribute to loneliness in SCI/D should be monitored and addressed. Ongoing research is also needed to develop a more culturally nuanced understanding of loneliness in disability. Protocol registration: https://osf.io/s6723/.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"916-926"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional spine therapy for neuropathic pain in individuals with paraplegia.","authors":"Tugrul Kocak, Yorck-Bernhard Kalke, Jianming Nie, Semra Kocak, Tobias Freitag, Heiko Reichel, Thomas Caffard, Hassan Awan Malik","doi":"10.1080/10790268.2025.2598981","DOIUrl":"10.1080/10790268.2025.2598981","url":null,"abstract":"<p><strong>Background: </strong>Infiltrations of the spine can be used to treat nociceptive or neuropathic pain. There is little data in the literature on the use of spinal injections in patients with paraplegia.</p><p><strong>Objective: </strong>The aim of this study is to determine whether patients with spinal cord injury experienced improvement in pain and spasticity following spinal injection.</p><p><strong>Methods: </strong>19 (9 female, 10 male) patients (5 patients AIS A, 5 patients AIS C, 9 patients AIS D), including 9 tetraplegic and 10 paraplegic patients, with 22 injection techniques and a follow-up of 4.2 months (1-12 months) were retrospectively examined in our spinal cord injury Center in 2022 and 2023. The pain intensity on the NRS (Numerical Rating Scale), the MAS (Modified Ashworth Scale) for the graduation of muscle tone and the Spinal Cord Independence Measurement (SCIM) were assessed before infiltration and as part of the follow-up examination.</p><p><strong>Results: </strong>Image intensifier-assisted facet and sacroiliac joint infiltrations were performed in 12 patients, CT-guided nerve root infiltrations and epidural injections in 10 patients with corresponding symptoms and image morphological correlate without complications. In all patients, a statistically significant reduction in pain on the NRS could be achieved (4.05 ± 1.84; <i>p</i> < 0.0001). A trend towards improvement was documented in the analysis of the MAS (0.14 ± 0.35; <i>p</i> = 0.08), whereas a significant improvement was statistically detected in the analysis of the SCIM (-15.59 ± 18.23; <i>p</i> = 0.0006).</p><p><strong>Conclusion: </strong>Our study represents the first retrospective exploratory analysis (phase I-style feasibility study) after spinal injection in patients with spinal cord injury. The primary results in terms of pain intensity, muscle tone and independence are promising and, in our view, represent a further therapeutic approach in addition to pharmacological and non-pharmacological therapy options. However, further investigations are necessary for this.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1045-1053"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in management of central cord syndrome: Insights from the New York State SPARCS database.","authors":"Kevin Yoon, Clarke I Cady-McCrea, Gabriel Ramirez, Caroline Thirukumaran, Lancelot Benn, Addisu Mesfin","doi":"10.1080/10790268.2025.2563957","DOIUrl":"10.1080/10790268.2025.2563957","url":null,"abstract":"<p><strong>Context: </strong>Multiple surgical and non-surgical management options exist for treating central cord syndrome (CCS) patients. However, the final treatment decision is based on a patient's presentation and surgeon's choice.</p><p><strong>Objectives: </strong>We aim to identify patient factors associated with decisions for surgical management versus non-surgical management of CCS and compare the outcomes of length of stay (LOS), patient disposition, readmission, complications, mortality, and total cost.</p><p><strong>Methods: </strong>This retrospective analysis of the New York Statewide Planning and Research Cooperative System (SPARCS) database identified CCS patients from January 1, 2012, to December 31, 2021. Surgical treatments were determined using International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. Chi-square, T-test, and multivariable regression were used to compare outcomes, with random intercepts and effects for facilities. P < 0.05 was considered significant.</p><p><strong>Results: </strong>Of 2214 patients, 41.24% (<i>n</i> = 891) underwent surgery. The majority (46.88%, <i>n</i> = 1038) were aged 40-65, followed by 46.48% (<i>n</i> = 1029) older than 65. Compared to non-surgically managed patients, surgically treated patients had a lower 90-day readmission rate, but a significantly longer length of stay, likelihood of non-home discharge, and total charge and cost. Of surgical modalities, posterior cervical decompression had the shortest mean LOS, probability of readmission, probability of readmission, and lowest mean total charge.</p><p><strong>Conclusion: </strong>Our study points toward surgery as having more favorable outcomes versus non-surgical management. The current study found that surgical management is associated with decreased probability of 90-day readmission and a non-significate decreased probability of mortality within 90 days of discharge.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1032-1044"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}