From the Research
Central cord syndrome is the most common form of incomplete spinal cord injury, with an increasing incidence due to the aging population, as reported in the most recent study 1. The incidence of central cord syndrome is estimated to be around 4-6 cases per 100,000 population annually, with a higher prevalence in older adults with pre-existing cervical spondylosis who experience hyperextension injuries 1.
Key Characteristics of Central Cord Syndrome
- It occurs most frequently in older adults, but can affect individuals of any age 1
- Men are affected more commonly than women, with a male-to-female ratio of approximately 3:1 to 4:1 2
- The syndrome typically results from damage to the central portion of the spinal cord, affecting the cervical region and causing greater weakness in the upper extremities compared to the lower extremities, along with varying degrees of sensory loss and bladder dysfunction 1
- Early recognition and appropriate management are crucial for optimizing outcomes, as some patients may experience significant neurological recovery, particularly in the lower extremities, though hand function often remains impaired 1
Diagnosis and Management
- Central cord syndrome is a clinical diagnosis defined by weakness greater in the upper than lower extremities and often prominent sensory complaints in the hands 1
- Nonoperative management may be appropriate in selected patients, but surgery is usually necessary in those with poor neurological recovery or further deterioration 1
- The optimal timing of surgical intervention has not been defined, but recent evidence suggests that early surgery (≤24 h) may lead to greater neurological recovery, shorter hospital stay, and fewer inpatient complications 1
Importance of Recent Evidence
The most recent study 1 provides the most up-to-date information on the incidence and management of central cord syndrome, and its findings should be prioritized in clinical decision-making.
Clinical Considerations
In clinical practice, it is essential to consider the anatomy and location of spinal cord compression, the presence of fractures or ligamentous instability, the temporal course of signs and symptoms, as well as the patient's overall health when managing central cord syndrome 1.