Abstract
Study Design:
A retrospective multicenter study.
Objectives:
To investigate the characteristics of bowel dysfunction in elderly people with traumatic central cord syndrome (TCCS).
Setting:
A total of 28 Rosai hospitals in Japan.
Methods:
The Rosai Hospital registry included 3006 persons with spinal cord injury during 1997–2007. The study subjects were 186 patients with TCCS (160 men, 26 women; mean age, 61.7±11.6 years, ±s.d.). Patients were divided according to age into the young group (<50 years, n=30), the middle-age group (50–69 years, n=112) and the elderly group (⩾70 years, n=44). We assessed the differences in bowel management techniques (spontaneous, rectal medications and manual emptying) and activity of daily living (ADL) with respect to bowel care at discharge among the three groups.
Results:
Continent spontaneous defecation was the most common bowel management method (50%, 93/186). The percentage of elderly subjects on continent spontaneous defecation (36.4%) was significantly less than that of the young group (66.7%; P<0.05). Furthermore, the percentage of elderly patients who required no bowel care (18.2%) was significantly less than those of the young (53.3%) and middle-age groups (41.1%; P<0.01). However, few differences in bowel care-related ADL were recognized among the three groups in patients who required manual emptying.
Conclusion:
The results identified significantly fewer patients aged ⩾70 years with ‘continent spontaneous defecation’ or ‘independent for bowel care’ compared with younger patients. The results also highlighted the clinical importance of bowel dysfunction associated with TCCS especially in elderly people.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Bosch A, Stauffer ES, Nickel VL . Incomplete traumatic quadriplegia: a ten year review. JAMA 1971; 216: 473–478.
Roth EJ, Lawler MH, Yarkony GM . Traumatic central cord syndrome: clinical features and functional outcomes. Arch Phys Med Rehabil 1990; 71: 18–23.
Shingu H, Ohama M, Ikata T, Katoh S, Akatsu T . A nationwide epidemiological survey of spinal cord injuries in Japan from January 1990 to December 1992. Paraplegia 1995; 33: 183–188.
Schneider RC, Cherry G, Pantek H . The syndrome of acute central cervical spinal cord injury, with special reference to the mechanics involved in hyperextension injuries of the cervical spine. J Neurosurg 1954; 11: 546–577.
Merriam WF, Taylor TKF, Ruff SJ, McPhil MJ . A reappraisal of acute traumatic central cord syndrome. J Bone Joint Surg 1986; 68B: 708–713.
Tow A-P, Kong KH . Central cord syndrome: functional outcome after rehabilitation. Spinal Cord 1998; 36: 156–160.
Penrod LE, Hegde SK, Ditunno JF . Age effect on prognosis for functional recovery in acute, traumatic central cord syndrome. Arch Phys Med Rehabil 1990; 71: 963–968.
Newey ML, Sen PK, Fraser RD . The long-term outcome after central cord syndrome: a study of the natural history. J Bone Joint Surg (Br) 2000; 82B: 851–855.
Krassioukov A, Eng JJ, Claxton G, Sakakibara BM, Shum S . Neurogenic bowel management after spinal cord injury: a systematic review of the evidence. Spinal Cord 2010; 48: 718–733.
Aito S, D’Andrea M, Werhagen L, Farsetti L, Cappelli S, Bandini B et al. Neurological and functional outcome in traumatic central cord syndrome. Spinal Cord 2007; 45: 292–297.
Dvorak MF, Fisher CG, Hoekema J, Boyd M, Noonan V, Wing PC et al. Factors predicting motor recovery and functional outcome after traumatic central cord syndrome. Spine 2005; 30: 2303–2311.
Ishida Y, Tominaga T . Predictors of neurologic recovery in acute central cervical cord injury with only upper extremity impairment. Spine 2002; 27: 1652–1658.
Maynard Jr FM, Bracken MB, Creasey G, Ditunno Jr JF, Donovan WH, Ducker TB et al. International standards for neurological and functional classification of spinal cord injury. American spinal injury association. Spinal Cord 1997; 35: 266–274.
Pouw MH, van Middendorp JJ, van Kampen A, Hirschfeld S, Veth RP, Curt A et al. Diagnostic criteria of traumatic central cord syndrome. Part 1: a systematic review of clinical descriptors and scores. Spinal Cord 2010; 48: 652–656.
van Middendorp JJ, Hosman AJ, Pouw MH, EM-SCI Study Group, Van de Meent H . ASIA impairment scale conversion in traumatic SCI: is it related with the ability to walk? A descriptive comparison with functional ambulation outcome measures in 273 patients. Spinal Cord 2009; 47: 555–560.
Furusawa K, Tokuhiro A, Sugiyama H, Ikeda A, Tajima F, Genda E et al. Incidence of symptomatic autonomic dysreflexia varies according to the bowel and bladder management techniques in patients with spinal cord injury. Spinal Cord 2011; 49: 49–54.
De Looze DA, De Muynck MC, Van Laere M, De Vos MM, Elewaut AG . Pelvic floor function in patients with clinically complete spinal cord injury and its relation to constipation. Dis Colon Rectum 1998; 41: 778–786.
Salles N . Basic mechanisms of the aging gastrointestinal tract. Dig Dis 2007; 25: 112–117.
Nakanishi N, Tatara K, Naramura H, Fujiwara H, Takashima Y, Fukuda H . Urinary and fecal incontinence in a community-residing older population in Japan. J Am Geriatr Soc 1997; 45: 215–219.
Acknowledgements
We thank the medical staff at the Rosai hospitals for their assistance. We also thank Dr Faiq G Issa (http://www.word-medex.com.au) for the careful reading and editing of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Furusawa, K., Tokuhiro, A., Ikeda, A. et al. Effect of age on bowel management in traumatic central cord syndrome. Spinal Cord 50, 51–56 (2012). https://doi.org/10.1038/sc.2011.90
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2011.90
Keywords
This article is cited by
-
Central cord syndrome definitions, variations and limitations
Spinal Cord (2023)
-
Bowel Dysfunction in Spinal Cord Injury
Current Gastroenterology Reports (2018)


