by EBSCO Medical Review Board
(CCS; Central Cervical Cord Syndrome; Central Cord Injury; Injury, Central Cord; Paralysis, Upper Extremity; Syndrome, Central Cord; Syndrome, Central Cervical Cord; Upper Extremity Paralysis; Acute Central Cord Syndrome)


Central cord syndrome (CCS) is an incomplete injury of the part of the spinal cord that is in the neck. This results in weakness in the arms and hands. Sometimes the legs are also affected.

Spinal Cord
Spinal Cord
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CCS happens after an injury that hyperextends the neck. This damages nerve fibers that bring message from the brain to the body. Some causes are:

  • Trauma , such as a car accident, sports injuries, and falls (most common)
  • Wear and tear of the spine due to aging
  • Abnormal structure of the spine
  • Tethered cord syndrome—abnormal attachment of the spinal cord to tissue around the spine
  • Osteoporosis—weakened bones
  • Spinal arthroplasties

Risk Factors

This problem is more common in men. It is also more common in older adults with spinal health problems, such as osteoporosis.


Problems may be:

  • Trouble lifting the arms and hands
  • Numbness and tingling
  • Problems with fine motor control, such as buttoning a shirt
  • Muscle weakness in the legs
  • Problems walking
  • Loss of bladder control


You will be asked about your symptoms and health history. A physical exam will be done. A neurological exam may also be done.

Images may be taken of the spine. These can be done with:


The goal of treatment is to manage symptoms. Choices are:

  • Physical therapy to improve strength, flexibility, and range of motion
  • Occupational therapy to help with daily tasks and self-care
  • Medicine to ease pain and swelling

Some people may need surgery if there is a large compression of the spinal cord fibers.


CCS is often caused by injury or accident. These are hard to prevent.


Christopher and Dana Reeve Foundation 

National Institute of Neurological Disorders and Stroke 


Canadian Spinal Research Organization 

Spinal Cord Research Centre 


Ameer MA, Stobart Gallagher MA, et al. Central Cord Syndrome. [Updated 2020 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:

Central cord syndrome information page. National Institute of Neurological Disorders and Stroke website. Available at: Accessed January 26, 2021.

Eckert MJ, Martin MJ. Trauma: Spinal Cord Injury. Surg Clin North Am. 2017 Oct;97(5):1031-1045.

Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: Accessed January 26, 2021.

Spinal cord injury—emergency management. EBSCO DynaMed website. Available at: Accessed January 26, 2021.

Traumatic brain injury and concussion. Centers for Disease Control and Prevention website. Available at: Accessed January 26, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 12/2020
  • Update Date: 01/26/2021