Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Introduction: Central cord syndrome has been reported to occur with particular frequency among older persons with cervical spondylosis who sustain hyperextension injury, it can be found in persons of any age and can be associated with various etiologies, injury mechanisms, and predisposing factors. This study aims to determine the efficacy of early decompression (within 24 hours) in comparison with conservative management for CCS. Methods: A randomized controlled trial performed between January 2015 to Deceremb 2016, at Kasr Alainy hospital, Cairo university where 30 patients with CCS divided into 2 groups, conservatively managed group and surgically managed group). Surgical group was the even order and conservative group was the odd order at presentation. We had performed a laminectomy for the surgical group. Clinical assessment on admission and 3 months follow-up using the American spinal injury association (ASIA) impairment scale, FIM (functional independence measure), spasticity (ashworth) scale, bladder function, and neuropathic pain according to present pain intensity scale (PPI). Results: The sample of the conservative group consisted of 11 male (73.3%) and 4 female subjects (26.7%) with a mean age of (58) years while surgical group, the sample consisted of 10 male (66.6%) and 5 female subjects (33.3%) with a mean age of (58.6) years. There is an improvement in our study-according to ASIA and FIM scales-in 4 patients of 15 (26.7%) with conservative management however we recorded an improvement in 8 patients (53.3%) who were operated surgically which is superior to conservative group

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