Efficacy of surgical treatment in traumatic central cord syndrome

Surg Neurol. 1997 Nov;48(5):435-40; discussion 441. doi: 10.1016/s0090-3019(97)00037-2.

Abstract

Background: Controversy surrounds the treatment of traumatic central cord syndrome (TCCS), as there are strong advocates for nonsurgical treatment for most patients. However, conservative treatment has been shown to yield a longer period of discomfort from pain and weakness in certain cases.

Methods: In a retrospective review of 114 patients presenting with acute or chronic TCCS from 1988-94, four different age groups were separately observed under different treatments. Motor and sensory recovery were assessed.

Results: Better results were achieved in younger patients, with or without radiographic abnormalities, and in patients with clinically correlated encroaching cord lesions who received early surgical decompression.

Conclusions: Surgical intervention for TCCS must be addressed with careful clinical and radiographic survey. Removal of offending lesions in the subacute period results in significant motor and sensory improvement in short-term and long-term follow-up.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Chi-Square Distribution
  • Female
  • Hand Strength
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neck Injuries / diagnostic imaging
  • Neck Injuries / physiopathology
  • Neck Injuries / surgery*
  • Retrospective Studies
  • Spinal Cord / diagnostic imaging
  • Spinal Cord / physiopathology
  • Spinal Cord / surgery*
  • Spinal Cord Injuries / diagnostic imaging
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / surgery*
  • Syndrome
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome