PMID- 36383244
OWN - NLM
STAT- MEDLINE
DCOM- 20230215
LR  - 20230223
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 32
IP  - 2
DP  - 2023 Feb
TI  - Early surgical intervention alleviates sensory symptoms following acute traumatic 
      central cord syndrome.
PG  - 608-616
LID - 10.1007/s00586-022-07447-w [doi]
AB  - PURPOSE: To investigate the impact of early versus delayed surgery on sensory 
      abnormalities in acute traumatic central cord syndrome (ATCCS). METHODS: Pressure 
      pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM) 
      and pain assessments were performed in 72 ATCCS patients (early vs. delayed 
      surgical treatment: 32 vs. 40) and 72 healthy subjects in this ambispective 
      cohort study. These examinations, along with mechanical detection threshold (MDT) 
      and disabilities of arm, shoulder and hand (DASH), were assessed at 2 years 
      postoperatively. RESULTS: Preoperatively, more delayed surgical patients had 
      neuropathic pain below level compared with early surgical patients (P < 0.05). 
      Both early and delayed surgical patients showed reduced PPT in common painful 
      areas and increased TS, while reduced CPM only existed in the latter (P < 0.05). 
      Reduced PPT in all tested areas, along with abnormalities in TS and CPM, was 
      observed in patients with durations over 3 months. Both incidences and 
      intensities of pain and pain sensitivities in common painful areas were reduced 
      in both treatment groups postoperatively, but only early surgical treatment 
      improved the CPM and TS. Follow-up analysis demonstrated a higher MDT and lower 
      PPT in hand, greater TS, greater DASH, lower pain intensities and higher 
      incidence of dissatisfaction involving sensory symptoms in delayed surgical 
      patients than in early surgical patients (P < 0.05). CONCLUSIONS: Central 
      hypersensitivity may be involved in the persistence of sensory symptoms in ATCCS, 
      and this augmented central processing may commence in the early stage. Early 
      surgical treatment may reverse dysfunction of endogenous pain modulation, thus 
      reducing the risk of central sensitization and alleviating sensory symptoms.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Chen, Kaiwen
AU  - Chen K
AD  - Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi 
      Road, Shanghai, 200040, China.
FAU - Nie, Cong
AU  - Nie C
AD  - Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi 
      Road, Shanghai, 200040, China.
FAU - Song, Huan
AU  - Song H
AD  - Department of Nursing, Huashan Hospital, Fudan University, Shanghai, 200040, 
      China.
FAU - Zhu, Yu
AU  - Zhu Y
AD  - Department of Physical Medicine and Rehabilitation, Upstate Medical University, 
      State University of New York at Syracuse, Syracuse, NY, 10212, USA.
FAU - Lyu, Feizhou
AU  - Lyu F
AD  - Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi 
      Road, Shanghai, 200040, China.
AD  - Department of Orthopedics, The Fifth People's Hospital, Fudan University, 
      Shanghai, 200240, China.
FAU - Jiang, Jianyuan
AU  - Jiang J
AD  - Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi 
      Road, Shanghai, 200040, China. jianyuanjiang05@126.com.
FAU - Zheng, Chaojun
AU  - Zheng C
AUID- ORCID: 0000-0002-1165-2528
AD  - Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi 
      Road, Shanghai, 200040, China. Cjzheng17@fudan.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221116
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Humans
MH  - Cohort Studies
MH  - *Central Cord Syndrome/complications/surgery
MH  - Pain Threshold
MH  - Pain Measurement
MH  - *Neuralgia
OTO - NOTNLM
OT  - Acute traumatic central cord syndrome
OT  - Central sensitization
OT  - Dynamic quantitative sensory testing
OT  - Dysesthetic pain
OT  - Pain classification
EDAT- 2022/11/17 06:00
MHDA- 2023/02/16 06:00
CRDT- 2022/11/16 11:14
PHST- 2022/05/24 00:00 [received]
PHST- 2022/11/03 00:00 [accepted]
PHST- 2022/10/09 00:00 [revised]
PHST- 2022/11/17 06:00 [pubmed]
PHST- 2023/02/16 06:00 [medline]
PHST- 2022/11/16 11:14 [entrez]
AID - 10.1007/s00586-022-07447-w [pii]
AID - 10.1007/s00586-022-07447-w [doi]
PST - ppublish
SO  - Eur Spine J. 2023 Feb;32(2):608-616. doi: 10.1007/s00586-022-07447-w. Epub 2022 
      Nov 16.