Traumatic Central Cord Syndrome.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY
Clinical Spine Surgery Pub Date : 2024-11-01 Epub Date: 2024-09-30 DOI:10.1097/BSD.0000000000001703
Matthew T Carr, James S Harrop, John K Houten
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引用次数: 0

Abstract

Central cord syndrome (CCS) is the most common form of incomplete spinal cord injury, with an increasing incidence with the aging population. This is a clinical diagnosis defined by weakness greater in the upper than lower extremities and often prominent sensory complaints in the hands. CCS is typically seen in individuals with underlying cervical canal stenosis from spondylosis who experience sudden forceful movement of the neck, especially hyperextension, resulting in contusion of the spinal cord. The prognosis in CCS is relatively favorable with improvement in neurological deficits, except for fine motor control of the hands. Neuropathic pain may persist even in those with excellent motor recovery. Nonoperative management may be appropriate in selected patients, but surgery is usually necessary in those with poor neurological recovery or further deterioration. The optimal timing of surgical intervention has not been defined, but recent evidence suggests that early surgery (≤24 h) may lead to greater neurological recovery, shorter hospital stay, and fewer inpatient complications. Management in any given patient must be considered in the context of the anatomy and location of spinal cord compression, the presence of fractures or ligamentous instability, the temporal course of signs and symptoms, as well as the patient's overall health.

创伤性中央脊髓综合征。
中央脊髓综合征(CCS)是不完全脊髓损伤中最常见的一种,随着人口老龄化的加剧,其发病率也在不断上升。这种临床诊断的特征是上肢比下肢更无力,手部通常有明显的感觉不适。CCS 通常见于因脊椎病导致颈椎管狭窄的患者,他们在颈部突然用力运动,尤其是过度伸展时,会导致脊髓挫伤。CCS 的预后相对较好,除手部精细运动控制外,神经功能缺损会有所改善。即使运动功能恢复良好,神经性疼痛也可能持续存在。非手术治疗可能适用于部分患者,但对于神经功能恢复不佳或病情进一步恶化的患者,通常需要进行手术治疗。手术干预的最佳时机尚未确定,但最近的证据表明,早期手术(≤24 小时)可使神经系统恢复更快,住院时间更短,住院并发症更少。对任何特定患者的处理都必须结合脊髓受压的解剖结构和位置、是否存在骨折或韧带不稳、症状和体征的时间进程以及患者的整体健康状况。
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来源期刊
Clinical Spine Surgery
Clinical Spine Surgery Medicine-Surgery
CiteScore
3.00
自引率
5.30%
发文量
236
期刊介绍: Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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