Central cord injury complicating acute cervical disc herniation in trauma

Study Design. A retrospective study on 24 patients with acute central cervi cal cord injury caused by traumatic disc herniation. Objectives. To determine the correlation of disc herniation with central co rd injury and to evaluate the role of anterior cervical decompression and i nterbody fusion in management of this injury. Summary of Background Data. Acute cervical disc herniation has been documen ted as a causative factor in spinal cord injury but has been infrequently r eported with central cord syndrome. Methods. Between 1989 and 1994, 24 patients with acute cervical disc hernia tion and central cord syndrome were studied. These patients underwent anter ior decompression and fusion, and were followed for 2 to 7 years, with an a verage follow-up period of 3 years and 8 months. The degree of disc herniat ion and neurologic scores were rated. Results. During follow-up period, the American Spinal Injury Association mo tor 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 r ate (P < 0.01), but no correlation was observed between severity of cord co mpression and neurologic scores (P > 0.05). Postoperative neurologic improv ement in patients with fracture or dislocation was very significantly slowe r (P < 0.01) than in those without these injuries. Conclusions. Far more common than previously expected, acute disc herniatio n in cervical spine injury is the one of principal cause for central cord s yndrome. Magnetic resonance imaging assessment and surgical intervention ar e required.