II. Pathophysiology
- Injury to the anterior two-thirds of the spinal cord
- Flexion injury or Anterior Spinal Artery injury
- Corticospinal tract injury
- Spinothalamic Tract injury
- Spinothalamic Tract involvement helps to distinguish from other Spinal Cord Syndromes
- Images
III. Causes
- Spinal cord crush injury
- Epidural Hematoma related Pressure Injury
- Hyperflexion injury in athletes (if bony instability)
-
Anterior Spinal Artery compression with secondary cord ischemia (affects anterior two thirds of spinal cord)
- Vascular disease (e.g. elderly)
- Cross-Clamping aorta (e.g. AAA repair)
IV. Signs
- Motor weakness (below injury level)
- Pain and Temperature sense loss (below injury level)
- Proprioception and vibratory Sensation are spared
V. Management
- Physical Therapy and Occupational Therapy
- Rehabilitation of motor function
VI. References
- Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
- Rodriguez, Winger, Poulo and Glunk (2023) Crit Dec Emerg Med 37(3): 23-9
- Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]