Central Cord Syndrome

Central cord syndrome (CCS) is a type of incomplete spinal cord injury. CCS is marked by damage to the nerve fibers that bring messages from the brain to the body. This condition affects how you can use your arms and hands, and in some cases, your legs. There may be a loss of sensation and motor control.

CCS is caused by damage to the central part of the spinal cord. This damage may occur when the neck is hyperextended. This can can be associated with:

• Bleeding in the spinal cord
• Edema (swelling created by fluid in connective tissues)
• Loss of blood supply to the area
• Syringomyelia (syrinx)—This is a cyst that in the spinal cord.

Common causes of injury include:

• Degenerative condition of spine (often found in older people)
• Pre-existing condition, such as being born with a narrow spine
• Trauma (eg, car accident, sports injuries, falls)

CSS can also be due to:

• Structural problems
• Tumors within the spinal cord

These factors increase your chance of developing CCS:

• Autoimmune disorder (eg, multiple sclerosis , neuromyelitis optica)
• Age: over 50 (more likely to have arthritis of the neck and a fall)
• Gender: male
• Participation in certain sports (eg, wrestling, diving)
• Pre-existing condition (eg, narrow spinal canal, spinal cord disease, dysfunction)

Tell your doctor if you have any of these risk factors.

If you have any of these symptoms, do not assume it is due to CCS. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Difficulty with fine motor control (eg, buttoning a shirt)
• Inability to lift arms and hands completely, or numbness and tingling
• Loss of bladder control
• Muscle weakness in legs, difficulty walking

If CCS is due to trauma, symptoms usually come quickly. Sometimes, however, symptoms may come more gradually.

Your doctor will ask about your symptoms and medical history. In addition to doing a physical exam, she may also do a neurologic exam, which includes assessing:

• Mental state
• Reflexes
• Vision

Tests may include:

• CT scan —a type of x-ray that uses a computer to make pictures of structures near and inside the spinal cord
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the spinal cord
• Myelogram —imaging test that uses a special dye to view the spinal cord and the area surrounding it
• X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones

Talk with your doctor about the best treatment plan for you. If the injury is due to trauma, you may need to spend a number of weeks in the hospital. Rehab can take 1-2 months. If you are young and have more muscle tone at follow-up evaluation, you have a better chance of recovering. Other predictors of recovery are:

• Level of education
• Muscle function at the time of the injury

Treatment options include the following:

To help reduce your chance of getting a spinal cord injury, take the following steps:

• Always wear a seatbelt.
• Avoid diving if you do not know how deep the water is.
• Do not drink and drive. Do not ride with someone who has been drinking.
• Remove obstacles in your house, like throw rugs, that could cause falls.
• Secure firearms.
• Use safe techniques and proper equipment when playing sports.