central cord syndrome

Central Cord Syndrome

Epidemiology

 

Most common pattern cord injury

 

Hyper-extension injury in middle aged man with osteoarthritic spine

 

Usually C3/4 and C4/5

 

Mechanism

 

Most common type / in older patient with pre-existing spondylosis / OPLL

- hyperextension injury

- compression of the cord

- anteriorly by osteophytes

- posteriorly by infolded ligamentum flavum

 

Management

Definition

 

Complete Lesion 

- bulbocavernosus reflex present 

- no cord function below lesion

- very poor prognosis for recovery

 

Incomplete Lesion

- bulbocavernosus reflex present

- some cord function below lesion

- good prognosis for recovery

 

Anatomy

 

Vertebral Canal narrowest at T8/9

- Also area of vascular watershed