Central Cord Syndrome (CCS)

What is central cord syndrome?

Central cord syndrome (CCS) is an injury to the central part of your spinal cord in your neck (cervical spinal cord). It can cause weakness in your arms, and sometimes in your legs.

Does central cord syndrome have other names?

Central cord syndrome is also known as incomplete spinal cord injury. Most people with this condition aren’t completely paralyzed.

Who does central cord syndrome affect?

CCS is often a result of a traumatic neck injury. When damage occurs to the small bones (vertebrae) in your neck, CCS can develop due to excess pressure on your spinal cord.

CCS can also be seen after traumatic injury in people over age 50 with arthritis in their neck resulting in narrowing of their spinal canal (spinal stenosis). Less commonly, central cord syndrome can be seen in people with tumors, vascular abnormalities and cavitation (syringomyelia) within the center of their spinal cord.

What is acute central cord syndrome?

Acute central cord syndrome can occur suddenly after a hyperextension injury of your neck (whiplash) resulting in damage to the central part of your spinal cord. It can result from traumatic injuries like car accidents and falls. Less commonly, acute central cord syndrome may be seen in nontraumatic injuries like centrally located tumors, vascular abnormalities and cavitation.

How common is central cord syndrome?

Central cord syndrome is the most common type of incomplete spine injury in the United States. There are about 18,000 new cases of spinal cord injury each year.

How does central cord syndrome affect me?

Central cord syndrome blocks the communication of the nerves between your brain and the parts of your body below the injury. CCS affects your cortical spinal tract, a pathway of your spinal cord that carries nerve impulses that help you move. The nerves traveling down your spinal cord are also organized with the nerves that go to your arm located in the inner part, and the nerves going to your legs on the outer part. Damage to the central part of your spinal cord will damage nerves going to your arms more than your legs. In addition, you may have numbness and difficulty walking.

Are there complications from central cord syndrome?

Some people with central cord syndrome may develop:

• Bladder problems.
• Bowel problems.
• Blood clots in their veins.
• Breathing problems.
• Low blood pressure.
• Numbness and weakness.
• Muscle spasticity.
• Sudden high blood pressure (autonomic dysreflexia).

What causes central cord syndrome?

Most commonly, CCS is caused by hyperextension of your neck (moving your head back too far) during a traumatic event (like a fall) in the presence of cervical spinal canal stenosis (narrowing of your spinal canal).

What are the symptoms of central cord syndrome?

Central cord syndrome blocks nerve signals between your brain and spinal cord (nervous system). A lack of nerve signals between your brain and your arms and hands is a hallmark indicator of central cord syndrome.

Blocked nerve signals typically cause symptoms in your arms and hands but may affect your legs, too. You may have:

• Aching.
• Burning.
• Tingling.
• Inability to make small movements with your hands (fine motor skills).
• Numbness in your hands or arms.
• Paralysis or weakness.
• Muscle spasticity.
• Difficulty walking.

Symptoms depend on how severe your condition or injury is. You may lose feeling below the injury site and lose bladder control (urinary incontinence). Some people can’t walk or develop gait disorders.

How is central cord syndrome diagnosed?

Your healthcare provider begins with a physical examination. They also ask you about your medical history, including any injuries.

What tests do healthcare providers use to diagnose central cord syndrome?

Healthcare providers use imaging tests to diagnose CCS, including:

• CT scan.
• Electromyogram.
• MRI.
• X-ray.

Healthcare providers may also use flexion and extension tests to see if — or how — you can move. During these tests, you move your chin down (flexion) and up (extension).

How is central cord syndrome treated?

Healthcare providers treat central cord syndrome using nonsurgical or surgical treatments, depending on the cause of your injury.

What nonsurgical treatments do healthcare providers use for central cord syndrome?

Healthcare providers use a variety of nonsurgical treatments to treat central cord syndrome:

• Immobilization: Healthcare providers may give you a rigid collar to wear that keeps your neck from moving. They may also use splints to help keep your hands in the correct position.
• Medications: Healthcare providers may prescribe medicines to relieve pain and reduce inflammation, like steroids.
• Occupational therapy: Specialists help you develop strategies for living with central cord syndrome, including exercises, adaptive devices and modifications to daily activities.
• Physical therapy: Specialists teach you exercises that build strength and flexibility, and offer assistive devices.

Will I need surgery for central cord syndrome?

You may need surgery for central cord syndrome if you have a compressed spinal cord. Healthcare providers may also operate if your cervical spine:

• Moves in ways that aren’t typical.
• Has trouble supporting weight.
• If there’s a tumor, vascular abnormality or cavitation of your spinal cord.

How soon after central cord syndrome treatment will I recover?

People who receive treatment soon after their injury have better chances of recovering some nerve function. Others, especially people over the age of 65, may recover nerve function more slowly or not at all.

How can I reduce my risk of central cord syndrome?

While there’s no guaranteed way to prevent acute central cord syndrome, you can help protect your spine from injury when you:

• Eliminate safety hazards to reduce your fall risk.
• Stay safe when working on a ladder or high surfaces.
• Wear protective equipment during contact sports and physical activities.

How can I prevent cervical spinal stenosis?

Take good care of your spine to reduce your risk of developing cervical spinal stenosis. To help protect your spine:

• Exercise regularly.
• Pay attention to how you sit and sleep.
• Protect your back when lifting heavy objects.
• Maintain healthy posture.

When should I see my healthcare provider?

If you’re seriously injured or in an accident, seek medical attention right away, especially if you have trouble moving your arms or legs, or you feel tingling or weakness.

What can I expect if I have central cord syndrome?

Most people with central cord syndrome recover some nerve function. If CCS affects your legs and bladder, you may improve in those areas first. Often, it takes longer to restore nerve signals to your hands.

Is central cord syndrome curable?

There’s no cure for central cord syndrome, and outcomes vary. Some people regain most, if not all, function in their arms, hands and legs. But some people have loss of function in their hands for the rest of their lives.

How long does it take to recover from central cord syndrome?

Recovery time is different for every person. Your age and the severity of the injury or condition affect your recovery. Generally, people over age 50 take longer to recover than younger people.

How do I take care of myself if I have central cord syndrome?

Talk with your healthcare provider about what to expect. Occupational and physical therapy can help you stay strong and develop coping strategies to help when daily activities are challenging.

A note from Cleveland Clinic

Central cord syndrome (CCS) is a condition that develops after an injury to your spinal cord in your neck (cervical spine). CCS affects nerve impulses to your limbs. Healthcare providers can use nonsurgical treatments and surgery to restore feeling and function to your arms, hands and legs.