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Controversies in the Management of Central Cord Syndrome

The State of the Art

Wagner, Peter J., MD, MMS1,a; DiPaola, Christian P., MD1,b; Connolly, Patrick J., MD1,c; Stauff, Michael P., MD1,d

doi: 10.2106/JBJS.17.00811
Current Concepts Review
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Disclosures

  • ➤ 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.

1UMass Memorial Medical Center, Worcester, Massachusetts

aE-mail address for P.J. Wagner: peter.john.wagner@gmail.com

bE-mail address for C.P. DiPaola: Christian.dipaola@umassmemorial.org

cE-mail address for P.J. Connolly: Patrick.connolly@umassmemorial.org

dE-mail address for M.P. Stauff: Michael.Stauff@umassmemorial.org

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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