Central cord syndrome (CCS)

Neck | Neurology | Central cord syndrome (CCS) (Disease)


Central cord syndrome (CCS) is a condition characterized by an acute injury of cervical spinal cord (SCI). It can affect a large and diverse group of patients.

It is marked by a disproportionately greater impairment of motor function in the upper extremities than in the lower ones, as well as by bladder dysfunction and a variable amount of sensory loss below the level of injury.

Symptoms associated with this condition are: inability to lift arms and hands completely, or numbness and tingling; difficulty with fine motor control like in buttoning a shirt; muscle weakness in legs, difficulty walking; loss of bladder control. Symptoms may come more gradually, but If CCS is due to trauma, symptoms usually come quickly.

Causes and Risk factors

Central cord syndrome (CCS) most often occurs after a hyperextension injury in an individual with long-standing cervical spondylosis. The syndrome also may be associated with fracture dislocation and compression fracture. CSS can also be due to tumors within the spinal cord.

These factors increase the chance of developing CCS: gender (male have an increase risk); age over 50, due to arthritis of the neck and a fall; autoimmune disorder like Multiple Sclerosis, Neuromyelitis optica; Pre-existing condition such as narrow spinal canal, spinal cord disease, and dysfunction; participation in certain sports like wrestling and diving.

Diagnosis and Treatment

Diagnosis is confirmed by test such as: Magnetic Resonance Imaging (MRI) and Computer Tomography (CT) scan, Myelogram and X-ray.

Treatment can be surgical or nonsurgical. Acute surgical intervention is not usually necessary unless there is significant cord compression. Nonsurgical treatment consists of immobilization of the neck with a cervical orthosis, steroids unless contraindicated, and rehabilitation with physical and occupational therapy. ...