Extended cord injury in acute traumatic central cord syndrome after operation

Central cord syndrome is the most common incomplete spinal cord injury, and it often occurs in patients suffering from a hyperextension injury. Early surgery has been advocated to improve the outcome and neurological function. However, extended spinal cord injury following anterior cervical discectomy and fusion for central cord syndrome rarely occurs and is seldom reported in the literature. We report a 61-year-old man who suffered from a hyperextension injury, which was diagnosed as traumatic central cord syndrome. Because of the ensuing instability and cord compression, he underwent anterior cervical discectomy and fusion. However, more severe myelopathy was observed postoperatively and extended cord injury was diagnosed based on the expansion of intramedullary high-intensity signal on T2-weighted magnetic resonance images. Patients and surgeons need to be informed of this uncommon but now recognized complication after anterior cervical discectomy and fusion for traumatic central cord syndrome.