Central cord syndrome: Mechanisms, clinical presentation, and management strategies

Abstract

Central Cord Syndrome (CCS) is a prevalent form of incomplete spinal cord injury (SCI) characterized by distinct motor and sensory deficits. This paper discusses the nuances of CCS, covering epidemiology, etiology, mechanisms, clinical presentation, diagnosis, predictive factors for outcomes, management strategies, and emerging therapeutic approaches. CCS accounts for a significant portion of SCIs, with trauma, particularly hyperextension injuries in individuals with preexisting spinal stenosis, being the primary cause. Patient demographics reveal skewed distributions in age, sex, and race, influencing outcomes and care approaches. Symptoms impact patients' quality of life extensively, ranging from motor dysfunction to neuropathic pain and bladder complications. Diagnosis involves a multifaceted approach utilizing clinical assessment tools, radiological imaging, and electrophysiological tests. Predictive factors for outcomes include age, time to presentation, and injury severity, guiding treatment decisions between conservative and surgical approaches. Initial management strategies focus on trauma assessment, neuroprotection, and preventing secondary injury. While established treatments have evolved, emerging therapies present promising avenues, including GM1 gangliosides, riluzole, minocycline, stem cell therapy, and transcutaneous electrical spinal stimulation. In conclusion, this paper sheds light on the multifaceted nature of CCS, exploring various aspects from epidemiology to emerging therapeutic approaches. It offers valuable insights for the advancement of care and outcomes in individuals affected by CCS.