Episode 19: Central Cord Syndrome

Host Jimmy McKay

Featured guest Bridget Ripa

Notes Alexis Lancaster

What is it?

  • Damage to the central portion of the spinal cord

 

How does it happen?

  • Hyperextension of the cervical spine is the typical cause
  • Inflammation or pressure on the cord centrally

 

Anatomy/Presentation

  • Tricky
  • Damages spinothalamic, corticospinal, and dorsal columns
  • Upper extremities weaker than lower extremities
  • Greater motor deficits than sensory deficits
  • The sensation of the sacral region is present

 

Differential diagnosis

  • The other spinal cord syndromes
    • Rely on clinical presentation
  • Imaging (CT/MRI)

 

Special tests

  • CT/MRI
  • Clinical presentations (UE deficits>LE)

 

Treatment

  • Medically stable first
  • Bowel/bladder program
  • Motor learning
  • Task-specific training
  • Weight-bearing
  • Neuromuscular re-education
  • Strengthening
  • Tone management
  • FES
  • Aerobic training
  • Positioning
  • Bracing/splinting
  • Locomotion if applicable
    • LE stronger than UE! So you will probably be walking
  • Keeping an eye on shoulder pain
  • Allow compensation in this population

 

How it will look on the NPTE

  • Upper involved more than lower (hallmark sign)
  • Mechanism of injury→ hyperextension injury