This 2009 narrative review covers the anatomy, pathophysiology, diagnosis, and surgical versus nonsurgical management of central cord syndrome (CCS) — the most common incomplete spinal cord injury. It addresses the core clinical controversy: when, if ever, should surgery be performed, and how early?
When an older patient with cervical spondylosis presents after a low-energy hyperextension mechanism with disproportionate hand and forearm weakness, think CCS — assess sacral sparing to confirm incomplete injury and obtain MRI to identify cord compression or instability that would prompt early surgical consultation.
For patients showing spontaneous neurologic improvement, conservative management is appropriate; reserve early decompression for those with radiographically confirmed pathology, progressive deficit, or spinal instability.
This 2009 narrative review covers the anatomy, pathophysiology, diagnosis, and surgical versus nonsurgical management of central cord syndrome (CCS) — the most common incomplete spinal cord injury. It addresses the core clinical controversy: when, if ever, should surgery be performed, and how early?
When an older patient with cervical spondylosis presents after a low-energy hyperextension mechanism with disproportionate hand and forearm weakness, think CCS — assess sacral sparing to confirm incomplete injury and obtain MRI to identify cord compression or instability that would prompt early surgical consultation.
For patients showing spontaneous neurologic improvement, conservative management is appropriate; reserve early decompression for those with radiographically confirmed pathology, progressive deficit, or spinal instability.