Central cord syndrome (CCS)
Central cord syndrome (CCS), an acute cervical spinal cord injury (SCI), was initially described by Schneider and colleagues in 1954. CCS most often occurs after a hyperextension injury in an individual with long-standing cervical spondylosis.
Injury may result from posterior pinching of the cord by a buckled ligamentum flavum or from anterior compression of the cord by osteophytes.3 Historically, spinal cord damage was believed to originate from concussion or contusion of the cord with stasis of axoplasmic flow, causing edematous injury rather than destructive hematomyelia. Studies have also shown that CCS probably is associated with axonal disruption in the lateral columns at the level of the injury to the spinal cord with relative preservation of the grey matter.
The syndrome also may be associated with fracture dislocation and compression fracture, especially in a congenitally narrowed spinal canal. CCS-related motor impairment results from the pattern of lamination of the corticospinal and spinothalamic tracts in the spinal cord. Age
CCS has a bimodal distribution; in young persons, CCS tends to result from trauma, while in older individuals, it is typically caused by falls sustained by persons with preexisting spondylosis.
• Symptoms occur following trauma (most commonly falls) and consist of upper and lower extremity weakness with varying degrees of sensory loss.