Traumatic Central Cord Syndrome: Neurological and Functional Outcome at 3 Years
Overview
Affiliations
Study Design: Retrospective cohort analysis with prospective follow-up.
Objectives: To evaluate neurological and functional recovery following central cord syndrome.
Setting: Northern Ireland, population 1.8 million.
Methods: Twenty-seven cords were identified in 1 year. Five managed conservatively and 22 with surgery. American Spinal Injury Association (ASIA) motor scores (AMS) were calculated to assess neurological recovery. Rotterdam scores assessed functional independence at 3 years.
Results: Average age was 62 years. Mechanism of injury was a fall with neck hyperextension in 81% patients. Average AMS in surgical patients improved from injury, preoperatively, postoperatively, 6 months and 3 years from 51, 81, 83, 90 to 96, respectively. Conservative patients improved from time of injury to day 10 from 57 to 86 and then fell to 84 at 6 months. By 3 years, this had recovered to 91. There was no statistical significant difference in AMS (P=0.15)/change in AMS (ΔAMS) (P=0.92) or percentage of motor deficit resolution (P=0.23) between groups at 3 years. Two patients underwent surgery within 48 h and achieved full motor recovery by 3 years, but this was not significant (P=0.2). ASIA score improvement had a positive correlation with age at injury. Patients treated with surgery had better Rotterdam scores at 3 years than those managed conservatively (P=0.05).
Conclusions: This study confirms the natural history of central cord syndrome. Although it demonstrates equivocal neurological recovery for both groups, patients treated with surgery regained a greater degree of functional independence.
Gorbacheva A, Goudarzi A, Vengsarkar V, Pierre C, Gerstmeyer J, Oskouian R Global Spine J. 2025; :21925682251321835.
PMID: 39957266 PMC: 11831611. DOI: 10.1177/21925682251321835.
Timing of decompression in central cord syndrome: a systematic review and meta-analysis.
Xu L, Zhong W, Liu C, Zhao H, Xiong Y, Zhou S Eur Spine J. 2024; 33(9):3593-3601.
PMID: 38625584 DOI: 10.1007/s00586-024-08244-3.
Treatment of acute traumatic central cord syndrome: a score-based approach based on the literature.
Kumar A, Wong J, Pillay R, Nolan C, Ling J Eur Spine J. 2023; 32(5):1575-1583.
PMID: 36912986 DOI: 10.1007/s00586-023-07626-3.
Li J, Shi D, Hua Z, Wang L Ther Clin Risk Manag. 2021; 17:23-29.
PMID: 33447038 PMC: 7800690. DOI: 10.2147/TCRM.S288076.
Dang T, Dong F, Fenati G, Rabiei M, Cerda M, Neeki M Clin Pract Cases Emerg Med. 2020; 4(2):267-271.
PMID: 32426690 PMC: 7220002. DOI: 10.5811/cpcem.2019.8.44201.