Diagnosis and treatment of acute central cervical cord injury

Objective To clarify the diagnosis and management of acute central cervical cord injury. Methods Eighty-nine patients with acute cervical central cord injury were retrospectively reviewed. Sixty-three patients were treated conservatively and 26 were treated surgically. There were two acute deaths. Eighty-seven patients were followed up for 3 months to 15 years. Results Their average neurological score (ASIA) was increased from 41.7 at admission to 83.1 at follow-up. Conclusions Acute central cervical cord injury should be differentiated from complete spinal cord injury, cervical myelopathy, cruciate paralysis and C8 nerve root injury. When compression of nerve tissue or cervical instability is identified, operative intervention should be indicated. The prognosis is less optimistic in the patients with severe primary injury and at old age.