New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
J Am Acad Orthop Surg. 2009 Dec;17(12):756-65. doi: 10.5435/00124635-200912000-00004.
Central cord syndrome is the most common type of incomplete spinal cord injury. This syndrome most often occurs in older persons with underlying cervical spondylosis caused by a hyperextension mechanism. It also occurs in younger persons who sustain trauma to the cervical spine and, less commonly, as a result of nontraumatic causes. The upper extremities are more affected than the lower extremities, with motor function more severely impaired than sensory function. Central cord syndrome presents a spectrum, from weakness limited to the hands and forearms with sensory preservation, to compete quadriparesis with sacral sparing as the only evidence of incomplete spinal cord injury. Historically, treatment has been nonsurgical, but recovery is often incomplete. Early surgical treatment of central cord syndrome remains controversial. However, recent studies have shown benefits, particularly of early surgery to decompress the spinal cord in patients with pathologic conditions revealed by radiography or MRI.
中央脊髓综合征是最常见的不完全性脊髓损伤类型。这种综合征最常发生在有潜在颈椎病变(由过伸机制引起)的老年人中。它也发生在因颈部创伤而致损伤的年轻人中,较少见于非创伤性原因。上肢比下肢更易受影响,运动功能比感觉功能受损更严重。中央脊髓综合征表现为一系列症状,从仅限于手部和前臂的无力,感觉保存,到完全性四肢瘫痪,只有骶部保留作为不完全性脊髓损伤的唯一证据。历史上,治疗是非手术的,但恢复往往不完全。中央脊髓综合征的早期手术治疗仍存在争议。然而,最近的研究表明,早期手术治疗有一定益处,特别是对影像学或 MRI 显示有病理改变的患者进行脊髓减压。