A cervical spinal cord injury involves damage to the spinal cord in the neck region, which can occur from trauma such as falls, vehicle accidents, or sports injuries. The spinal cord carries nerve signals between your brain and body, so injury can affect movement and sensation in your arms, legs, and torso, depending on the level and severity. Injuries are classified as complete (no function below the injury level) or incomplete (some function preserved). Even seemingly minor neck injuries can potentially damage the spinal cord, which is why neck trauma requires careful assessment.

Recovery depends on the injury’s severity and completeness. Incomplete injuries, where some nerve pathways remain intact, have better recovery potential than complete injuries. Many patients with incomplete cervical cord injuries regain significant function through rehabilitation, though this often takes months to years. The most rapid improvement typically occurs in the first six months. Some people recover fully, particularly if the injury was mild, whilst others retain permanent impairment. Early surgical stabilisation when needed, followed by intensive rehabilitation, maximises recovery potential.

Central cord syndrome is a specific type of incomplete spinal cord injury affecting the centre of the cervical cord. It typically occurs when the neck hyperextends during a fall, especially in older adults with pre-existing spinal stenosis. The hallmark is that arms are more affected than legs, and hands are often particularly weak. Many patients can still walk but struggle with arm and hand function. The condition often improves with time and rehabilitation, though hand function may remain impaired. Treatment focuses on preventing further injury, managing symptoms, and maximising recovery through physiotherapy.

Initial treatment prioritises spinal stabilisation to prevent further damage, often requiring immobilisation and sometimes surgery to decompress the cord and stabilise the spine. High-dose medications may be used in some cases, though protocols continue evolving. Once stable, intensive rehabilitation becomes central, involving physiotherapy, occupational therapy, and sometimes specialist equipment. Treatment addresses not just movement but also bowel and bladder function, pain management, and preventing complications. The multidisciplinary approach continues long-term, adapting as recovery progresses. Even years after injury, continued therapy can yield further improvements.

Warning signs include difficulty with coordination or balance, weakness in your arms or legs affecting walking or fine motor tasks, numbness or altered sensation in multiple limbs, and bowel or bladder dysfunction. Some people describe a heavy feeling in their legs or notice their hands have become clumsy. Neck pain isn’t always present, particularly if compression develops gradually from degenerative changes rather than trauma. These symptoms suggest myelopathy, which requires prompt assessment. Early surgical decompression when appropriate can prevent progression and optimise recovery potential.