Controversies in the Management of Central Cord Syndrome: The State of the Art.

Abstract

➤ Traumatic central cord syndrome is an incomplete spinal cord injury characterized primarily by disproportionate motor and sensory loss in the upper extremities compared with the lower extremities.➤ Initial management of central cord syndrome includes immobilization in a rigid cervical orthosis, maintaining mean arterial pressure, and performing serial neurologic examinations.➤ Treatment with high-dose methylprednisolone is no longer recommended for the treatment of central cord syndrome.➤ Central cord syndrome is generally treated surgically, but the timing and surgical approach depend on injury characteristics, including the injury pattern, neurologic examination and its evolution, and patient comorbidities.➤ Early surgery may be performed safely in the appropriate patient, but there is little evidence to support the notion that earlier surgery affects neurologic outcomes.