C-Spine

Anterior Cord Syndrome

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Anterior Cord Syndrome, Anterior Spinal Artery Syndrome

  • Pathophysiology
  1. Flexion injury or Anterior Spinal Artery injury affecting Spinothalamic Tracts and Corticospinal tracts
  2. Spinothalamic Tract involvement helps to distinguish from other Spinal Cord Syndromes
  3. Images
    1. CordSyndrome.jpg
  • Causes
  1. Spinal cord crush injury
  2. Epidural Hematoma related pressure injury
  3. Hyperflexion injury in athletes (if bony instability)
  4. Anterior Spinal Artery compression with secondary cord ischemia (affects anterior two thirds of spinal cord)
    1. Vascular disease (e.g. elderly)
    2. Cross-Clamping aorta
  • Signs
  1. Motor weakness (below injury level)
  2. Pain and Temperature sense loss (below injury level)
  3. Proprioception and vibratory sensation are spared
  • References
  1. Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
  2. Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]