Causes of spinal cord injuries include motor vehicle accidents (44%), acts of violence (24%), falls (22%), sports (two-thirds of these are from diving accidents) (8%), and other (2%). Statistics show that the summer is the worst time for spinal cord injuries, with July having the highest incidence. They happen more frequently on weekends and at nights. Most people who get spinal cord injuries are male (82%) and the median age at the time of injury is 31.7 years. About 10,000 Americans suffer SCI every year.
Learn more about the anatomy of the spine, how spinal injuries occur, and the level of the spinal cord injury.
SCI THERAPY
There are several types of sci or spinal cord injury treatment. Rehabilitation hospitals provide several different types of specialists to help in the recovery process.
There is a lot of exciting research being done on SCI therapies, including new medications, using the patient’s own white blood cells (macrophages), and transplantation of amniotic or embryonic cells into the injured area. While these treatments are not yet available for the treatment of SCI patients, the progress that is being made gives hope to those with SCI and their families. You may qualify to participate in research studies on experimental spinal cord injury treatments. Also, read about stem cell research into spinal cord injury treatments.
Central Cord Syndrome
Central cord syndrome is the most common form of incomplete acute spinal cord injury characterized by motor impairment in both the upper limb and lower limb, variable degree of sensory loss below the level of injury, and bladder dysfunction. The motor impairment is disproportionate and is usually greater in upper limb as well as lower limb.
Central cord syndrome is more common among elderly with long-standing cervical spondylosis but, it can occur in younger person also and may be associated with various type of injuries and predisposing factors.
Location of fibres in the spinal cord
Fibers carrying the motor and sensory impulses for lower limbs are located in the most peripheral part of the cord, whereas fibers carrying impulses for the upper limb and voluntary bowel and bladder function are more centrally located. Sacral tracts are located most peripherally & are usually spared from injury.
Causes
Central cord syndrome is usually the result of trauma to the spinal cord.
The commonest mode of injury is hyperextension injury in a patient of
long-standing cervical spondylosis when the spinal cord is pinched by
the ligamentum flavum or anterior compression by the osteophytes.
Sometimes, central cord syndrome may be a result of fracture dislocation
and compression fracture especially if the spinal cord is congenitally
narrow.
Central cord syndrome may also be caused due to bleeding and hematoma
formation.
Symptoms
- History of trauma usually fall
- Weakness in both upper and lower limbs
- Variable degree of sensory loss
- Loss of pain & temperature sensation
- Loss of sensation of light touch and position
History of trauma
Site of lesion in CCS
The disproportionate motor involvement observed in central cord syndrome is due to location of nerve fibres and tracts and is consistent with the lamination pattern of the tracts in the spinal cord.
Diagnosis
X-ray: Fracture & dislocation can be diagnosed and flexion/extension view will be helpful in diagnosing stability of ligaments.
CT scan: CT scan of cervical spine may show a narrow spinal canal.
MRI scan: MRI can clearly demonstrate the presence of hematoma, impingement from bone or intervertebral disc.
Treatment
There is no cure for central cord syndrome. Treatment is usually supportive and includes medical and surgical treatment as well as physical therapy. Indications for surgery are rare and need for surgical treatment has to be individualized. Physical therapy mainly helps to preserve the range of motion.
Prognosis
Prognosis for central cord syndrome is variable. Patient receiving early treatment recover better. Walking is recovered in most cases with some residual disability. Improvement starts in lower limb, followed by bladder and lastly seen in upper limbs.
Treatment of Spinal Cord Injuries