An incomplete traumatic injury to the cervical spine is Central Cord Syndrome (CCS). The cervical spinal cord includes the part of the spinal cord that runs through the neck. The traumatic injury will cause a weakening of the arms. The traumatic injury will not cause complete paralysis.
CAUSES
Existing arthritis changes in the bones of the neck typically takes place in people with central cord syndrome. A traumatic experience, including a car accident, where the neck is extended with a great amount of force can squeeze the spinal cord. This happens because the spinal cord canal could be narrow. There will often be no major fracture or break in the bones of the neck. The spinal cord may remain stable as well. After the spine is squeezed, bruising, bleeding, and swelling may happen in the center of the spinal cord. The center of the spinal cord controls the motion of the arms whereas the outside has nerves going to the legs. For this reason, after traumatic injury there may be a weakening in the arms instead of the legs. Patients with CCS often will not have normal function of their arms or hands. Patients with CCS can often walk and regain function in the legs.
SYMPTOMS
Common symptoms of CCS include a weakening in the upper extremities and less severe weakness in the lower extremities. Patients may experience difficulty performing routine, simple tasks including doing buttons, writing, or walking. Other common symptoms are decreased sensation and trouble urinating. Neck pain may occur but changes depending on the traumatic event.
CCS occurs more often in patients over the age of 50 who also have a neck hyperextension injury. CCS occurs more commonly in male patients than females. CCS could occur in patients of any age but it is less common. Often athletes are the younger patients with CCS who have had hyperextension injuries to the neck or ruptured discs that compress the spine.
SEEKING MEDICAL CARE
Seek medical attention immediately if experiencing any of the symptoms mentioned above after an injury, accident, traumatic event. Medical workers will evaluate and assess to figure out the cause of the symptoms. A patient may be sent to a spine specialist after examination. A patient may also be referred to a neurosurgeon if symptoms have appeared slowly and are not caused after an injury or accident.
TESTING AND DIAGNOSIS
While evaluating a patient with CCS symptoms, a patient will be asked for a medical history, experience examinations, cervical magnetic resonance imaging (MRI), computed tomography (CT) scan, and plain cervical spine X-rays.
TREATMENT
Nonsurgical treatment
A nonsurgical approach is often used when neurological function is improving. This type of treatment may include a stiff cervical collar to immobilize the neck. Also may need to consult with an occupational therapist or a physical therapist.
Surgery
Surgery is not commonly needed. Surgery may be used if there is significant compression of the spinal cord. With advanced technology and imaging, compression of the spinal cord can more easily be diagnosed and decompressed in surgery. If bony arthritis changes are the cause of a narrowing spinal canal and spinal cord compression, surgery is not often performed until the patient shows a notable recovery. Then the patient may be reassessed. If there is a lesion that can be treated surgically and remarkable residual motor weakness after a time of recovery, or if neurological deterioration occurs, then surgery may become an option. Pre-surgical scans may be required beforehand.
OUTLOOK
Some patients will CCS may experience an unprompted recovery of motor function while other patients may notice improvement 6 weeks post injury. If swelling or edema is the main cause, patients may recover soon after initially feeling weakness. It is often that function in the legs that return first. Next will be bladder control and then function of the arms. The last to improve is usually hand function. If bleeding or a stroke in the spinal cord caused the central legion then recovery most likely will not happen. Patients who are young with CCS have a better recovery than older patients. It is seen that younger patients will typically be able to walk and perform routine tasks. Older patients are less likely to be able to recover to that extent.
