ABSTRACT
Central cord syndrome [CCS] is a frequently incomplete cervical spinal cord injury. It is characterised by a disproportionately greater motor deficit of the upper than lower extremities, with varying degrees of sensory loss below the level of the lesion and bladder dysfunction. The purpose of this paper is to describe in detail the clinical and radiological characteristics, evaluate prognosis of patients with CCS after follow-up and discuss the most probable pathophysiological mechanisms. The authors evaluated five patients [mean age 62.8 years] who sustained CCS after cervical spinal trauma. Falls were the most common aetiology followed by motor vehicle accidents. Mean total ASIA motor score on admission was 68.4 +/- 13.93, mean admission upper and lower motor score were 26.8 k 10.85 and 41.6 +/- 7.08 respectively. The admission total motor score was significantly different from 3 months [p < 0.05] and 2 years [p 0.001] follow-up total motor scores. There was an improvement of motor and bladder function at 3 months after the injury. All patients had spondylosis and cervical canal stenosis with obliteration of the anterior subarachnoid space over multiple levels identified on magnetic resonance imaging [MRI]. TI-weighted MRI showed no areas of high signal corresponding to subacute haemorrhage. Instead, high signal was seen in all patients on T2-weighted MRI that was interpreted as focal oedema. Lamirgxtorny, generally from C3-C6 without facetectomy and fixation, was performed in three patients. The general outcome of patients was good, despite the fact that complications such as chronic pain and hyperpathia are common