Summary
Twenty-two patients with subaxial acute traumatic central cord syndrome (CCS) without
fracture or dislocation who underwent surgery between 1995 and 2002 were reviewed,
retrospectively. There were 13 males and nine females ranging in age from 24 to 84
years (mean 61.2). Falls were the most common injury (68%), followed by motor vehicle
accidents (32%). All patients had dynamic cervical lateral radiographs and magnetic
resonance imaging (MRI). Cord compression was present in all cases and cervical instability
in 11. Associated pathology included disc herniation in seven patients, cervical spondylosis
(CS) in 11 and ossification of the posterior longitudinal ligament (OPLL) in four.
Anterior decompression and fusion was performed in 12 patients with 1- or 2-level
lesions. Posterior decompression and fusion was performed for multilevel lesions in
11 patients, including one patient who required re-operation. The interval between
injury and surgery ranged from 1 to 37 days (mean 8.0). Postoperatively, all patients improved clinically. We conclude that
surgical management of subaxial acute traumatic CCS without fracture or dislocation
improved neurological status and prevented delayed neurological deterioration in our
patients.
Keywords
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References
- The syndrome of acute central cervical spinal cord injury.J Neurosurg. 1954; 11: 546-577
- Acute central cervical spinal cord syndrome: aetiology, age incidence and relationship to the orthopaedic injury.Paraplegia. 1977; 14: 251-258
- The syndrome of acute central cervical spinal cord injury revisited.Surg Neurol. 1980; 14: 251-257
- Reanalysis of central cervical cord injury management.Neurosurgery. 1984; 15: 367-372
- Central cord syndrome.Clin Neurosurg. 1991; 37: 612-621
- Cervical spine injuries in the elderly.J Bone Joint Surg Br. 1994; 76: 877-881
- Hyperextension injuries of the spine: the pathogenesis of damage to the spinal cord.J Bone Joint Surg. 1974; 56: 1655-1662
- The mechanism of injury to the spinal cord in the neck without damage to the vertebral column.J Bone Joint Surg Br. 1951; 33: 543-547
- Cervical spine hyperextension injuries: MR findings.Radiology. 1991; 180: 245-251
- Cervical spine injury in the elderly.Skeletal Radiol. 2001; 30: 1-7
- Spinal cord injury without radiographic abnormality in adults.Spinal Cord. 1999; 37: 726-729
- Long term function following the central cord syndrome.Paraplegia. 1990; 28: 178-185
- A reappraisal of acute traumatic central cord syndrome.J Bone Joint Surg Br. 1986; 68: 708-713
- The long-term outcome after central cord syndrome.J Bone Joint Surg Br. 2000; 82: 851-855
- Traumatic central cord syndrome: clinical features and functional outcomes.Arch Phys Med Rehab. 1990; 71: 18-23
- Intermediate-term outcome of cervical spinal cord-injured patients older than 50 years of age.Spine. 1997; 22: 1189-1192
- Central cord syndrome: functional outcome after rehabilitation.Spinal Cord. 1998; 36: 156-160
- The role of decompression for acute incomplete cervical spinal cord injury in cervical spondylosis.Spine. 1998; 23: 2398-2403
- Central cord injury complicating acute cervical disc herniation in trauma.Spine. 2000; 25: 331-336
- Deterioration following spinal cord injury.J Neurosurg. 1987; 66: 400-404
- Functional recovery after decompressive spine operation for cervical spine fracture.Neurosurgery. 1987; 20: 742-746
- Anterior decompression and arthrodesis of the cervical spine: long-term motor improvement. Part II: improvement in complete traumatic quadriplegia.J Bone Joint Surg Am. 1992; 74: 683-692
- Anterior decompression and arthrodesis of the cervical spine: long-term motor improvement. Part I: improvement in incomplete traumatic quadriparesis.J Bone Joint Am. 1992; 74: 671-682
- Clinical outcomes of cervical spinal cord injuries without radiographic evidence of trauma.Spinal Cord. 1998; 36: 567-573
- The effectiveness of surgery on the treatment of acute spinal cord injury and its relation to pharmacological treatment.Neurosurgery. 1994; 35: 240-249
- Early versus delayed surgery for acute cervical spinal cord injury.Clin Orthop. 1999; 359: 104-114
- Traumatic central cord syndrome: results of surgical management.J Neurosurg (Spine 1). 2002; 97: 25-32
Article info
Publication history
Accepted:
April 21,
2004
Received:
December 28,
2003
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.