Central Cord Syndrome (CCS), also referred to as central cervical cord syndrome, occurs due to a spinal cord injury that affects the functioning of the upper limbs. In this condition, the brain can send and receive signals from the body below the injury level; however, this ability is considerably reduced. CCS occurs when the large nerve fibres that connect the spinal cord and brain get damaged.
One of the main causes of CCS is trauma to the head or neck, causing the spinal cord injury after it hits the spine. It also can occur due to a herniated disc or bone spur. When the vertebral column weakens due to age, it can result in CCS. A good example of CCS is Brown-Sequard syndrome, where the spinal cord gets partially damaged due to a penetrating or a blunt trauma to the back or the neck region.
Symptoms of CCS include paralysis, loss of control over the movement of arms and hands, impairment of leg movements and sensory loss below the injury site. Some people may also suffer from loss of bladder control. In case of Brown-Sequard syndrome, the person can experience loss of sense of touch and vibration. Also, the person would not be able to experience temperature and pain.
The severity of the symptoms is dependent on the extent of nerve damage, and that is why symptoms can vary from person to person.
CCS is usually diagnosed with the help of MRI images. The images allow the specialist to observe the injury in much greater detail. Sometimes, CT scans and X-rays are also used. These methods of diagnosis are used when the specialist fears fractures or dislocations in the neck region. Other than these methods of diagnosis, there are no special blood or laboratory tests to get a definitive diagnosis of CCS.
Typically, acute surgical intervention is not required to treat CCS. With the help of CT scans and MRIs, specialists are able to check for spinal cord compression, herniated disc or other lesions; and once the diagnosis is definitive, a surgery can help to decompress the affected area of the spine.
If the patient is suffering from narrowing of the spinal canal or the anterior bony ridges, no surgery is performed until the patient recovers. Thereafter, the patient is reassessed and a decision is taken then whether to perform a surgery or not. This is dependent on the cause of CCS. Usually, surgery is performed when the patient experiences spinal instability or neurological problems.
Most patients suffering from CCS are treated using nonsurgical treatment methods. These involve immobilising the neck using cervical orthosis and giving the patient steroids to reduce inflammation and swelling. After a period of recovery, the patient would have to undergo occupational and physical therapy to enhance mobility and to restore the basic daily living activities.
Outlook for central cord syndrome varies from person to person. Prognosis is better for younger patients, when compared to patients who are 50 or more. Usually, if the syndrome occurs due to a trauma, the person can regain neurological functions with proper therapy and rehabilitation. The outcome is more positive for patients who receive medical treatment immediately after their injury.
Most patients regain their ability to walk, though some impairment does remain. Also, with time and therapy, patients generally gain control over their bladder and arms. Hand function is the last thing to recover.