Central cord injury complicating acute cervical disc herniation in trauma

Study Design. A retrospective study on 24 patients with acute central cervical cord injury caused by traumatic disc herniation. Objectives. To determine the correlation of disc herniation with central cord injury and to evaluate the role of anterior cervical decompression and interbody fusion in management of this injury. Summary of Background Data. Acute cervical disc herniation has been documented as a causative factor in spinal cord injury but has been infrequently reported with central cord syndrome. Methods. Between 1989 and 1994, 24 patients with acute cervical disc herniation and central cord syndrome were studied. These patients underwent anterior decompression and fusion, and were followed for 2 to 7 years, with an average follow-up period of 3 years and 8 months. The degree of disc herniation and neurologic scores were rated. Results. During follow-up period, the American Spinal Injury Association motor score in 24 patients was increased to 86.46 +/- 10.22 from 47.79 +/- 19.66. The age of the patients was very negatively correlated with recovery rate (P < 0.01), but no correlation was observed between severity of cord compression and neurologic scores (P > 0.05). Postoperative neurologic improvement in patients with fracture or dislocation was very significantly slower (P < 0.01) than in those without these injuries. Conclusions. Far more common than previously expected, acute disc herniation in cervical spine injury is the one of principal cause for central cord syndrome. Magnetic resonance imaging assessment and surgical intervention are required.