What is the role of imaging studies in the diagnosis of central cord syndrome (CCS)?

Updated: May 21, 2020
  • Author: Michelle J Alpert, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Magnetic resonance imaging (MRI), computed tomography (CT) scanning, and the production of plain radiographs of the cervical spine can facilitate the diagnosis of central cord syndrome. [7] If vertebral fracture is seen with the central cord syndrome, then neurologic recovery can be different. With vertebral fracture, neurologic deficits are generally more severe, but more early recovery can be seen. [22]

Radiographic films of the cervical spine delineate fractures and dislocations, as well as the degree and extent of spondylotic changes. Flexion/extension views assist in the evaluation of ligamentous stability.

CT scanning of the cervical spine shows spinal canal compromise and allows the indirect approximation of the degree of spinal cord impingement.

MRI demonstrates direct evidence of spinal cord impingement from bone, a disc, or a hematoma. [9]  MRI T2-signal intensity can be helpful in evaluating patients for future neurologic deficits. If there is increased T2-signal intensity, then more severe initial neurologic deficits generally exist; however, the patient is less likely to experience neurologic deterioration. If there is no increased T2-signal intensity, then the initial injury is less severe but is more likely to undergo early neurologic deterioration. [23]

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