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This article has been peer reviewed. It is the author’s final published version in Global Spine Journal, Volume 9, Issue 1, May 2019, Pages 89S-97S.

The published version is available at Copyright © Divi et al.


Study Design: Narrative review.Objectives:To provide an updated overview of the management of acute traumatic central cord syndrome (ATCCS).

Methods: A comprehensive narrative review of the literature was done to identify evidence-based treatment strategies forpatients diagnosed with ATCCS.

Results: ATCCS is the most commonly encountered subtype of incomplete spinal cord injury and is characterized by worsesensory and motor function in the upper extremities compared with the lower extremities. It is most commonly seen in thesetting of trauma such as motor vehicles or falls in elderly patients. The operative management of this injury has been historicallyvariable as it can be seen in the setting of mechanical instability or preexisting cervical stenosis alone. While each patient should beevaluated on an individual basis, based on the current literature, the authors’ preferred treatment is to perform early decom-pression and stabilization in patients that have any instability or significant neurologic deficit. Surgical intervention, in theappropriate patient, is associated with an earlier improvement in neurologic status, shorter hospital stay, and shorter intensivecare unit stay.

Conclusions: While there is limited evidence regarding management of ATCCS, in the presence of mechanical instability orongoing cord compression, surgical management is the treatment of choice. Further research needs to be conducted regardingtreatment strategies and patient outcomes.

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