Yelamarthy PKK, Chhabra HS, Vaccaro A, et al. - A systematic review was conducted according to the PRISMA 2009 guidelines by the researchers in order to ascertain the management and prediction of acute traumatic cervical central cord (ATCCS) syndrome established by Spinal Cord Society and Spine Trauma Study Group. A total of 37 out of 770 articles dealing with management, the timing of surgery, complications or prognosis of ATCCS were recognized. out of 37, 15, ten and 12 were regarding management strategy, the timing of surgery and the prognosis of ATCCS, respectively. Therefore, with early surgery (< 24 h), it was evident that patients with ATCCS secondary to vertebral fracture, dislocation, traumatic disc herniation or instability had better results. The necessity of high-quality prospective randomized controlled trials to solve the controversy about early surgery vs conservative management and delayed surgery whether recovery would heighten or if there would be a neurological deterioration was concluded in individuals of ATCCS secondary to extension injury in the stenotic cervical canal without fracture/fracture-dislocation/traumatic disc herniation/instability. Moreover, till such time decision on surgery and its timing should be left to the interpretation of the physician, weighing on the pros and cons related to the particular individuals and including the well-informed patient and relatives in decision making.