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Central Cord Syndrome
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Central cord syndrome is a common presentation following trauma, particularly in the elderly. A structured approach to assessment of the neurological findings and consideration of the reasons to operate as listed earlier will form the basis for an excellent answer.
Trauma in the Elderly
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
A central cord syndrome is commonly caused by a simple fall. Degenerative changes reduce the diameter of the spinal canal, and hyperextension results in compression on the cervical cord between anterior cervical osteophytes and inward buckling of the posterior ligamentum flavum or a cervical disc. Patients present with greater weakness of the arms than the legs with a variable and inconsistent sensory loss in the upper limbs. There is often evidence of frontal head injury. Central cord syndrome is often misdiagnosed because radiographs of the cervical spine usually show no obvious acute injury, and the complex neurological signs are not recognized.31
Head and spinal injuries
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Central cord syndrome is the most common type of incomplete spinal cord injury. It is usually seen following hyperextension injury to the spine in patients with an acquired narrow spinal canal. The centremost region of the spinal canal is a vascular watershed zone, which renders it more susceptible to injury from oedema. The long-tract fibres passing through the cervical spinal cord are somatotopically arranged such that the cervical fibres are located more medially than the fibres serving the lower extremities.
Effects of a contusion load on spinal cord with different curvatures
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Qian-qian Yu, Si-qing Liu, Jian-jie Wang, Meng-lei Xu, Wen-xuan Zhang, Li-ming Cheng, Rui Zhu
Variation of stress distribution reflects the situation during injury to some degree. Figures 7 and 8 show the maximum von Mises stress in the middle transverse cross section of gray matter loaded from back to front and from front to back load subject to different spinal curvatures under 40% compression ratio. With back-to-front load, the stress mainly located around the central canal and central region especially in the straight curvature, and thus central cord syndrome had a high probability of occurrence. This explains why the closer to the central tissue, the more serious the damage (Schneider et al. 1954). The high stress in the straight curvature affected a larger region compared to the other two curvatures and maybe more seriously damaged. The front-to-back load can be given arise by several degenerative factors, such as disc herniation, ligament ossification and osteophyma (Xiaofei et al. 2013). With the load, the anterior horn of the spinal cord was most affected and symptoms of the anterior cord syndrome may become more predominant. Scenarios with different curvatures were observed similar stress distribution, but the high stress had larger action area in the scenario with the kyphotic curvature. Thus, pathological curvature was more vulnerable when shocked, and lordotic curvature showed some benefits to some degree from the view of stress distribution.
Prediction of functional recovery six months following traumatic spinal cord injury during acute care hospitalization
Published in The Journal of Spinal Cord Medicine, 2018
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
Then, criteria used in the present study to define the occurrence of spasticity can be debated. Because the definition of spasticity and the agreement on clinical scales of spasticity vary widely, there is no reliable instrument to measure spasticity available. Although our criteria were based on the recent spasticity literature in terms of clinical measurement of spasticity23,44 and the importance of patient's perception,24 strong validation studies are still lacking. Types of medical complications considered in this study are relatively small. Authors recognized that other complications and secondary conditions related or not to the SCI may have also influence outcome following SCI. Finally, a future study should investigate factors associated with functional outcome in individuals with central cord syndrome and without spinal instability since they were excluded from this study.
The standing and walking assessment tool for individuals with spinal cord injury: A qualitative study of validity and clinical use
Published in The Journal of Spinal Cord Medicine, 2019
Kristin E. Musselman, Jean-François Lemay, Kristen Walden, Anne Harris, Dany H. Gagnon, Molly C. Verrier
It was noted by most PTs that patients with central cord syndrome were challenging to stage as “they can't sit up at the edge of the bed because they have poor postural control, but they could have like [near normal muscle strength] in their legs” [Site 1].