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What to Know About Central Cord Syndrome?

Medically Reviewed by Dany Paul Baby, MD on October 19, 2022

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What Is Central Cord Syndrome?

Central cord syndrome is a type of incomplete spinal cord condition that affects the middle portion of your spinal cord. An incomplete spinal cord syndrome affects specific structural or functional regions in the spinal cord but does not cause complete paralysis. Individuals with these conditions retain some sensory and motor functions but typically only have limited limb movement, particularly in the arms.

Due to this condition, the brain’s ability to send and get signals from different body parts is reduced but not completely blocked. Specifically, the condition affects the nerve fibers that relay information from the cerebral cortex to the spinal cord. These fibers are critical for hand, arm, and leg movements. Sometimes, the condition also impacts bladder functions, causing bladder retention (an inability to empty the bladder).

Central Cord Syndrome Causes

According to a 2016 study, accidents are the most widely reported cause of central cord syndrome. These could be motor accidents, sports injuries, or falls. Almost 50% of central cord syndrome occurrences are due specifically to falls. Conditions like spinal stenosis, which cause your spinal cord to narrow, can also lead to central cord syndrome.

Additionally, central cord syndrome is more common in people with arthritis. In some cases, the spinal canal (which houses the spinal cord) becomes narrow, and when the head tilts back too far, it can compress the spinal cord. This pressure leads to bruising, bleeding, and sometimes swelling. It usually does not break the bones in the neck and the spine, but it compresses the nerves. This is especially common in people over the age of 50 due to the declining strength of their vertebrae and discs, which causes the spinal cord to become narrow.

The nerves that could be affected are located along the spinal cord and regulate various bodily functions. Nerves monitoring hand functions are at the center of the cord, while those that connect to the legs are spread around the periphery. Since central cord syndrome primarily affects the middle portion of the spinal cord, it affects arm movements more than leg movements. 

Central Cord Syndrome Symptoms

Symptoms of central cord syndrome may include:

  • Inability to lift your arms and hands
  • Weakness in the legs
  • Inability to urinate or feel the sensation of urinating
  • Pain in the neck
  • Numbness or tingling sensations 
  • Struggling with fine motor control skills like shaving, brushing teeth, handwriting, or playing a musical instrument
  • Difficulty walking

Central Cord Syndrome Diagnosis

Your doctor usually checks your medical history and will run some tests to analyze your general health, as well as your neurological functions. This may require magnetic resonance imaging (MRI), computed tomography (CT) scans, and x-rays.

An MRI scan is a common choice since it gives your doctor three-dimensional images of your body that can indicate any signs of compression in your spinal cord and the surrounding tissues. CT scans are the best option to understand the integrity of your spine’s bone structure, though. CT scans also provide a clear view of the contents of the spinal cord and the surrounding structures. X-rays, meanwhile, detect any possible fractures in the spine.

Your doctor may ask you to stretch your neck to determine the ease of movement. This may include moving your chin down (flexion) and up (extension). Sometimes, your doctor will take x-rays while you do neck stretches to check for any instability. These x-ray images may help your doctor decide whether you’ll need spinal surgery or have to wear a cervical collar to stabilize your spine.

Central Cord Syndrome Treatment

While there’s no cure for this condition, some individuals regain most of their normal functions eventually. Treatment options depend on the severity of the condition and include nonsurgical and surgical options.

Some nonsurgical treatment options include stabilizing the neck using a cervical collar, physical therapy, and occupational therapy. Doctors generally recommend surgery only in cases where there is severe spinal cord compression. Additionally, if bony arthritis is determined to be the cause of compression, doctors usually wait for the individual to recover before doing surgery.

That being said, some research has linked early surgery in cases where it is needed to an increased chance of complete recovery, and surgery also helps those who encounter repeated spinal cord compression.

Central Cord Syndrome Recovery

Recovery from central cord syndrome depends on the individual case. People typically recover most of their motor functions within six weeks of an injury. In instances where swelling causes symptoms, recovery may happen earlier. In most cases, people first recover motor functions in their legs and then regain bladder control, followed by hand movements.

Younger adults are more likely to recover from the condition, regain their ability to walk, and carry out other functions quickly.

What to Know About Central Cord Syndrome

Here are a few things to keep in mind about this condition:

  • Research suggests there are roughly 17,000 to 18,000 new cases of spinal cord injuries every year in the U.S. Central cord syndrome is the most widely reported incomplete spinal cord injury.
  • Central cord syndrome is also the most commonly found spinal cord injury in the U.S., with roughly 11,000 cases every year.
  • You can reduce the risk of central cord syndrome occurrence by exercising regularly, keeping a good posture during your regular activities, and taking care of your back when you lift heavy objects.
  • If you participate in sports, make sure you wear appropriate protective equipment, especially if you play any contact sport.
  • If you’re diagnosed with this condition, ask your doctor what to expect and discuss the possible methods to help with your daily activities.

Show Sources

SOURCES:
Ameer, M. A., Tessler, J., Gillis, C. C. StatPearls, “Central Cord Syndrome,” StatPearls Publishing, 2022.
American Association of Neurological Surgeons: “Central Cord Syndrome.”
Brain Facts: “Central Cord Syndrome.”
Cleveland Clinic: “Central Cord Syndrome (CCS).”
JSM Neurosurgery and Spine: “Central Cord Syndrome: A Review of Epidemiology, Treatment and Prognostic Factors.”
National Institute of Neurological Disorders and Stroke: “Central Cord Syndrome.”
RISE: “Ten Examples of Fine Motor Skills.”
Winchester Hospital: “Central Cord Syndrome.”
World Neurosurgery: “The Central Cord Score: A Novel Classification and Scoring System Specific to Acute Traumatic Central Cord Syndrome.”

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