Central cord syndrome is a type of incomplete spinal cord injury predominantly involving central spinal cord structures of the cervical spinal cord. It occurs most often following acute traumatic spinal cord injury, often in patients with preexisting cervical spondylosis. Patients older than 50 years are at increased risk of developing central cord syndrome due to vertebral degeneration and ligamental weakening, which can cause narrowing of the spinal canal. These changes increase the risk of spinal cord impairment following a cervical hyperextension injury.
Patients with central cord syndrome present with motor impairment that is more prominent in the upper extremities than the lower extremities, with weakness and loss of fine motor control in the hands and arms. Patients may also have other associated symptoms consistent with spinal cord dysfunction, including sensory loss or dysesthesias below the level of the lesion, as well as urinary and/or bowel dysfunction. The severity of neurologic impairment correlates with the severity and extent of the spinal cord injury.
The prognosis is variable and depends on the extent of injury, although most patients with traumatic central cord syndrome will experience some degree of neurologic recovery. Patients treated with surgery in an expedited fashion tend to experience improved outcomes.
Emergency: requires immediate attention
Central cord syndrome
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Codes
ICD10CM:
S14.129A – Central cord syndrome at unspecified level of cervical spinal cord, initial encounter
SNOMEDCT:
282787000 – Central cord syndrome
S14.129A – Central cord syndrome at unspecified level of cervical spinal cord, initial encounter
SNOMEDCT:
282787000 – Central cord syndrome
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Differential Diagnosis & Pitfalls
- Disk herniation (see cervical radiculopathy, lumbar radiculopathy)
- Spinal stenosis
- Spinal cord injury / trauma / fracture
- Spinal infarct
- Spinal arteriovenous malformation
- Cauda equina syndrome
- Multiple sclerosis
- Transverse myelitis
- Neuromyelitis optica
- Neurosarcoidosis
- Spinal infections (eg, West Nile virus)
- Vertebral osteomyelitis
- Ankylosing spondylitis
- Spondylolisthesis
- Amyotrophic lateral sclerosis
- Aortic dissection
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Last Reviewed:10/28/2021
Last Updated:05/31/2023
Last Updated:05/31/2023