Central Cord Syndrome Redefined

Avila, Mauricio J.; Hurlbert, R. John

doi:10.1016/j.nec.2021.03.007

Cited by 15 publications

(10 citation statements)

References 41 publications

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“…The association between CCS and syringomyelia has extensively been documented in the medical literature, although these findings have only rarely been reported as caused by spondylo-disco-arthropathic alterations in the cervical spine. Moreover, the classical presentation of CCS is usually related to traumatic events rather than degenerative processes, even if cervical spondylotic alterations have been reported among the risk factors for this type of injury 12…”

Section: Discussionmentioning

confidence: 99%

‘Tumour-like’ lesion caused by cervical discal instability

Santoro,

Morselli,

Cirullo

et al. 2024

BMJ Case Rep

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We present the case of a man in his 40s who sought medical attention due to central cord syndrome. MRI findings demonstrated contrast uptake, spinal swelling, syrinx formation and narrowing of the spinal canal. We encountered two potential scenarios:when malignancy is suspected, the patient would undergo a biopsy. However, if the lesion is ultimately determined to be benign, the patient would have been subjected to an avoidable risk of neurological damage associated with the procedure. Conversely, addressing the lesion as a result of a degenerative process (discal instability), performing an anterior approach for interbody fusion with an underlying malignant process could lead to substantial delays in the diagnosis, finally producing a poor outcome. A comprehensive imaging workup was conducted to rule out malignancy. We hypothesised that discal instability was responsible for the observed findings. The patient was successfully treated with anterior cervical decompression and fusion, without complications. Follow-up evaluations confirmed remission of the condition.

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Section: Discussionmentioning

confidence: 99%

‘Tumour-like’ lesion caused by cervical discal instability

Santoro,

Morselli,

Cirullo

et al. 2024

BMJ Case Rep

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“…Although there is no clear, universally agreed-upon definition of CCS, the clinical presentation includes a greater loss of function in the arms and hands, relative to the lower extremities. Although CCS occurs in younger persons due to high energy impact injuries, in older persons this type of injury is caused by cervical hyperextension from a fall where pre-existing cervical stenosis is present (contributing to spinal cord compression) and is not 10.3389/fncel.2022.1017153 always associated with spine fracture or dislocation (Avila and Hurlbert, 2021;Ameer et al, 2022). CCS has traditionally been considered to have a higher rate of recovery than other types of SCI, however, a recent publication where individuals with CCS were matched with non-CCS incomplete SCI (by severity and neurological level of injury, age), demonstrated that CCS individuals had less recovery compared with incomplete SCI (Blasetti et al, 2020).…”

Section: Age At Time Of Spinal Cord Injury and The Clinical Populationmentioning

confidence: 99%

Improving translatability of spinal cord injury research by including age as a demographic variable

Stewart

Jones

Gensel

2022

Front. Cell. Neurosci.

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Pre-clinical and clinical spinal cord injury (SCI) studies differ in study design, particularly in the demographic characteristics of the chosen population. In clinical study design, criteria such as such as motor scores, neurological level, and severity of injury are often key determinants for participant inclusion. Further, demographic variables in clinical trials often include individuals from a wide age range and typically include both sexes, albeit historically most cases of SCI occur in males. In contrast, pre-clinical SCI models predominately utilize young adult rodents and typically use only females. While it is often not feasible to power SCI clinical trials to test multi-variable designs such as contrasting different ages, recent pre-clinical findings in SCI animal models have emphasized the importance of considering age as a biological variable prior to human experiments. Emerging pre-clinical data have identified case examples of treatments that diverge in efficacy across different demographic variables and have elucidated several age-dependent effects in SCI. The extent to which these differing or diverging treatment responses manifest clinically can not only complicate statistical findings and trial interpretations but also may be predictive of worse outcomes in select clinical populations. This review highlights recent literature including age as a biological variable in pre-clinical studies and articulates the results with respect to implications for clinical trials. Based on emerging unpredictable treatment outcomes in older rodents, we argue for the importance of including age as a biological variable in pre-clinical animal models prior to clinical testing. We believe that careful analyses of how age interacts with SCI treatments and pathophysiology will help guide clinical trial design and may improve both the safety and outcomes of such important efforts.

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“… 1 , 2 The cervical hyperextension injury is denoted by compression of spinal cord against the ligamentum flavum (posteriorly) and posterior aspects of the intervertebral discs and vertebral bodies (anteriorly). 3 , 4 In the late 1800s, Sir William Thorburn reported a series of nine cervical spinal injuries in which one patient demonstrated hand function to be more severely affected than leg function. 5 , 6 He hypothesized that this unique symptom was caused by a central gray matter hemorrhage in the spinal cord.…”

Section: Introductionmentioning

confidence: 99%

A Novel Radiological Scoring System for Anterior Longitudinal Ligament Injuries

Li,

Sun,

et al. 2024

IJGM

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Background and Aim Cervical hyperextension injury is very frequent with anterior longitudinal ligament (ALL) injury, and the ligament damage has a remarkable effect on whether and what type of operation should be performed. This study aims to establish a new scoring system for the accurate diagnosis of ALL damage. Methods The imaging data of the consecutive patients was measured and scored by four radiologists. Intraoperative exploration was performed by three surgeons. The crude and adjusted odds ratios (cOR and aOR) and receiver operating characteristic curve (ROC) were constructed to assess the diagnostic accuracy of the scoring system. Results A total of 255 patients with cervical spine trauma were included in this study. There was no statistical difference in the relationship between demographics and ALL injuries (P > 0.05). Thickness of prevertebral soft tissue (aOR = 11.922, P = 0.004), intervertebral disk angle (aOR = 13.21, P = 0.002), avulsion fracture of the anterior edge of the vertebral body (aOR = 13.844, P = 0.029), ALL disrupted in T1-weighted sequence (aOR = 18.349, P < 0.001), and high signal area in T2-weighted sequence (aOR = 20.898, P = 0.002) had significantly higher diagnostic accuracy. The scoring system’s sensitivity and specificity were 94.0% and 88.1%, respectively, and the accuracy was 90.8%. Conclusion The study established a new scoring system for ALL injuries based on the analysis of a series of clinical data and statistics. A total of five scoring items, a total score of 7 points, and an ALL injury may be diagnosed when the score is not less than 3 points. This scoring system enables an efficient and accurate diagnosis of all injuries.

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Central Cord Syndrome Redefined

Cited by 15 publications

References 41 publications

‘Tumour-like’ lesion caused by cervical discal instability

‘Tumour-like’ lesion caused by cervical discal instability

Improving translatability of spinal cord injury research by including age as a demographic variable

A Novel Radiological Scoring System for Anterior Longitudinal Ligament Injuries

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