Central Cord Syndrome
(CCS; Central Cervical Cord Syndrome; Central Cord Injury; Injury, Central Cord; Paralysis, Upper Extremity; Syndrome, Central Cord; Syndrome, Central Cervical Cord; Upper Extremity Paralysis; Acute Central Cord Syndrome)
Central cord syndrome (CCS) is an incomplete injury of the center of the spinal cord. When this happens in the neck it results in weakness in the arms and hands. Sometimes the legs are also affected.
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CCS can happen after an injury that hyperextends the neck. This damages nerve fibers that bring message from the brain to the body. It can sometimes make a space in the spinal cord called a syrinx. Some causes are:
- Trauma , such as a car accident, sports injuries, and falls (most common)
- Wear and tear of the spine due to aging
- Abnormal structure of the spine
- Tethered cord syndrome—abnormal attachment of the spinal cord to tissue around the spine
- Osteoporosis—weakened bones
- Spinal arthroplasties
CCS can also happen when a person has a tumor on or near their spinal cord.
This problem may be more common in men. It is also more common in older adults with spinal health problems, such as osteoporosis.
A person with CCS may have:
- Trouble lifting their arms and hands
- Numbness and tingling
- Problems with fine motor control, such as buttoning a shirt
- Muscle weakness in the legs
- Problems walking
- Loss of bladder control
The doctor will ask about symptoms and health history. A physical exam will be done. A neurological exam may also be done.
Images may be taken of the spine. These can be done with:
The goal of treatment is to manage symptoms. Choices are:
- Physical therapy to help with strength, flexibility, and range of motion
- Occupational therapy to help with daily tasks and self-care
- Medicine to ease pain and swelling
Some people may need surgery if there is a large compression of the spinal cord fibers.
CCS is often caused by injury or accident. These are hard to prevent.
- Central cord syndrome. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/central-cord-syndrome.
- Eckert, M.J. and Martin, M.J. Trauma: Spinal Cord Injury. Surg Clin North Am, 2017; 97 (5): 1031-1045.
- Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury.
- Spinal cord injury—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/spinal-cord-injury-emergency-management.
- Traumatic brain injury and concussion. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/TraumaticBrainInjury/index.html.
- Rimas Lukas, MD
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