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Review Question - QID 6855

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QID 6855 (Type "6855" in App Search)
A 67-year-old retired steelworker was involved in a motor vehicle accident and sustained a midcervical spinal cord injury. Radiographs and MRI scans reveal severe cervical stenosis and spondylosis without fractures or dislocations. Neurologic examination reveals an ASIA C spinal cord impairment with greater motor involvement of the upper extremities than the lower extremities. What is the probability that the patient eventually will become ambulatory?

2% to 5%

3%

10/336

15% to 20%

10%

33/336

35% to 45%

24%

81/336

60% to 70%

29%

96/336

Greater than 90%

34%

113/336

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The patient sustained an incomplete spinal cord injury known as central cord syndrome. Central cord syndrome characteristically has disproportionate involvement of the upper extremities with the lower extremities being relatively spared. It is most commonly seen after cervical injuries in elderly patients with spondylosis and spinal stenosis, often without fracture. Penrod and associates noted that 29 of 30 patients under 50yo with central cord syndrome (ASIA C and D) ultimately walked. The poorest prognosis, however, was in ASIA C patients older than age 50, in which only 7 of 17 (40% walked).

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