A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.
METHODS
Case report with review of the literature.


OBJECTIVE
To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy.


BACKGROUND
Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature.


METHODS
Case study with extensive review of the literature.


RESULTS
The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement.


CONCLUSIONS
Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.
Dickerman
Rob D
RD
North Texas Neurosurgical Associates, Department of Neurosurgery, HCA Medical Center of Plano, Plano, TX, USA. drrdd@yahoo.com
Lefkowitz
Michael
M
Epstein
Joseph A
JA
D000058:Accidental Falls; D000368:Aged; D001915:Braces; D002574:Cervical Vertebrae; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000628:therapy; D013169:Spondylolysis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D013577:Syndrome; D014057:Tomography, X-Ray Computed