Recurrent central cord syndrome at the level of a solid cervical vertebral fusion

A case of a solid cervical vertebral fusion that failed to protect against recurrent central cord syndrome at the same spinal level is described.

To alert clinicians to the potential for incomplete spinal cord lesions at the same level as cervical vertebral fusions.

The clinical symptomatology of central cord syndrome is discussed and the advantages of T2-weighted magnetic resonance imaging in such cases is considered. No prior reports of central cord syndrome occurring directly posterior to a solidly fused disc segment were found in the literature.

The clinical and T2-weighted magnetic resonance imaging features associated with central cord syndrome are presented. The traumatized region developed immediately posterior to the site of an anterior cervical diskectomy and uncovertebral osteophytectomy between the fourth and fifth cervical vertebrae with bone grafting that had been performed more than 3 years earlier.

Symptoms of the central cord syndrome resolved over the course of 4 months with no other intervention other than the use of a Philadelphia cervical collar. Five years later, the patient remained symptom free.

This case illustrates that clinicians must be aware of the potential occurrence of central cord syndrome in patients with solidly fused cervical segments, and that cervical fusion does not necessarily protect against future incomplete spinal cord injury, such as central cord syndrome, at the level of the fusion.