Central Cord Syndrome

Emergency evaluation, diagnosis, and management of the most common incomplete spinal cord injury

Aaron Wey, MD, FAAOS, FACS

Adult & Pediatric Spine Surgeon

Literature reviewed through September 2026

Version 1.0 · Updated 2026-09-26

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A patient

A 72-year-old man trips on a curb, strikes his forehead, and walks into your department. His legs work. He cannot button his shirt.

His cervical CT is read as “degenerative changes, no acute fracture.”

Introduction

Speaker notes · Introduction

Welcome. Over the next 45 minutes I want to change how you think about the older patient who falls, hits their forehead, and tells you their hands feel like they are wearing thick gloves.

Central cord syndrome is the most common incomplete spinal cord injury you will see, it is becoming more common as the population ages, and it is missed or under-treated in the emergency department far more often than a fracture-dislocation because the CT is frequently normal.

This talk is built for the people who see these patients first: residents on the consult pager, emergency physicians, and advanced practice providers. Every recommendation is referenced; the small citation chips on the slides can be clicked to show the source, and the full reference list with PubMed links is available online.

References on this slide

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