What is central cord abutment?
Central Cord Abutment (CAA) refers to the physical contact made by the spinal cord or its covering membrane, the dura mater, with the posterior or posterior-superior aspect of an intervertebral disc or osteophytes (bony growths) in the spinal canal. This contact can lead to compression and potential damage to the spinal cord.
CAA is most commonly associated with conditions such as degenerative disc disease, where aging and wear and tear cause bulging or herniation of the intervertebral discs. Osteoarthritis, which causes bony overgrowths (osteophytes), can also contribute to CAA.
CAA is a significant finding, especially in the presence of neurological symptoms, as it can compress neural elements, including the spinal cord itself, the nerve roots, and the blood supply. This compression can result in various symptoms, including:
Pain: Central cord abutment can lead to neck pain, mid-back pain, or low back pain.
Neurological deficits: CAA can cause a variety of neurological impairments depending on the location of the compression and the severity of spinal cord injury. These deficits can include sensory changes (numbness, tingling), motor weakness, impaired reflexes, and coordination difficulties.
Radicular symptoms: If nerve roots are affected, CAA can cause radiating pain down the arms or legs along with sensory and motor changes in the affected nerve root distribution.
Myelopathy: Severe compression of the spinal cord can lead to a condition called myelopathy, characterized by progressive damage to the spinal cord. This can result in significant neurological deficits and potentially irreversible symptoms.
Diagnosing central cord abutment typically involves reviewing the patient's symptoms, performing a thorough physical and neurological examination, and using imaging studies like MRI or CT scans. These imaging tests can visualize the spinal canal and identify compression or abutment of the spinal cord or nerve roots by the disc or osteophytes.
Treatment for central cord abutment aims to relieve the pressure on the spinal cord and address any associated symptoms. It can include conservative approaches such as pain medication, physical therapy, and spinal injections. In more severe cases, surgical intervention may be necessary to remove the offending disc material or osteophytes and create more space for the spinal cord and nerve roots.
Early recognition of central cord abutment is essential to minimize potential neurological damage. If you experience persistent spinal pain accompanied by neurological symptoms like weakness, numbness, or coordination problems, it's crucial to seek prompt medical evaluation and appropriate treatment.