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Central Cord Syndrome

(CCS; Central Cervical Cord Syndrome; Central Cord Injury; Injury, Central Cord; Paralysis, Upper Extremity; Syndrome, Central Cord; Syndrome, Central Cervical Cord; Upper Extremity Paralysis; Acute Central Cord Syndrome)
  • Definition

    Central cord syndrome (CCS) is a type of incomplete spinal cord injury. CCS is marked by damage to the nerve fibers that bring messages from the brain to the body. This condition affects how you can use your arms and hands, and in some cases, your legs. There may be a loss of sensation and motor control.
    Spinal Cord
    Spinal Cord
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  • Causes

    CCS is caused by damage to the central part of the spinal cord. This damage may occur when the neck is hyperextended. This can be associated with:
    • Syringomyelia (syrinx)—a cyst in the spinal cord
    • Loss of blood supply to the area
    • Bleeding in the spinal cord
    • Swelling
    Common causes of injury include:
    • Trauma , such as car accident, sports injuries, and falls
    • Degenerative condition of spine—often found in older people
    • Pre-existing condition, such as being born with a narrow spine
    CSS can also be due to:
    • Structural problems
    • Tumors within the spinal cord
  • Risk Factors

    Males over 50 are more likely to have this condition. Risk factors that increase your chances of developing CCS include:
    • Autoimmune disorder, such as multiple sclerosis and neuromyelitis optica
    • Pre-existing condition, such as narrow spinal canal, spinal cord disease, and tethered cord
    • Participation in certain sports, such as wrestling and diving
  • Symptoms

    Symptoms of CCS may include:
    • Inability to lift arms and hands completely, or numbness and tingling
    • Difficulty with fine motor control, such as buttoning a shirt
    • Muscle weakness in legs, difficulty walking
    • Loss of bladder control
    If CCS is due to trauma, symptoms usually come quickly. Sometimes, however, symptoms may come more slowly.
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. A neurologic exam may also be done.
    Images may be taken of your spinal cord. These can be done with:
  • Treatment

    Talk with your doctor about the best treatment plan for you. Rehab can take a long time for some patients. If you are young and have more muscle function, you have a better chance of recovering.
    Treatment options include the following:
    Nonsurgical Treatment
    In most cases, surgery is not needed. Often treatment involves:
    • Restricting neck movement
    • Giving steroids
    • Doing physical and occupational therapy
    Surgery is needed if there is a large compression of the spinal cord fibers. Surgery may also be done after a period of recovery. For example, if you still have cord compression after a recovery period.
  • Prevention

    To help reduce your chance of getting a spinal cord injury, take the following steps:
    • Avoid diving if you do not know how deep the water is.
    • Always wear a seatbelt.
    • Do not drink and drive. Do not ride with someone who has been drinking.
    • Remove obstacles in your house, like throw rugs, that could cause falls.
    • Use safe methods and proper equipment when playing sports.
    • Secure firearms.

    Christopher and Dana Reeve Foundation

    National Institute of Neurological Disorders and Stroke


    Canadian Spinal Research Organization

    Spinal Cord Research Centre


    Check for safety: a home fall prevention checklist for older adults. Centers for Disease Control and Prevention website. Available at: Published 2005. Accessed November 20, 2014.

    Clinical Syndromes. J Spinal Cord Med. 2007;30:215-224.

    Cortez R, Levi AD. Acute Spinal Cord Injury. Current Treatment Options in Neurology. 2007;9:115-125.

    Finnoff JT, Midlenberger D, et al. Central cord syndrome in a football player with congenital spinal stenosis. Am J Sports Med. 2004;32:516-521.

    NINDS central cord syndrome information page. National Institute of Neurological Disorders and Stroke website. Available at: Updated October 24, 2014. Accessed November 20, 2014.

    Rich V, McCaslin E. Central cord syndrome in a high school wrestler: a case report. J Athl Train. 2006;41:341-344.

    Spinal cord injury—acute management. EBSCO DynaMed website. Available at: Updated December 10, 2014. Accessed November 20, 2014.

    Spinal cord injury—chronic management. EBSCO DynaMed website. Available at: Updated August 11, 2014. Accessed November 20, 2014.

    Spinal cord injury (SCI): fact sheet. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention website. Available at: Updated November 4, 2010. Accessed November 20, 2014.

    Visocchi M, Di Rocco F, et al. Subacute clinical onset of post-traumatic myelopathy. Acta Neurochir. 2003;145: 799-804.

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