Anterior Cord Syndrome


Anterior Cord Syndrome, Anterior Spinal Artery Syndrome

  • Pathophysiology
  1. Injury to the anterior two-thirds of the spinal cord
  2. Flexion injury or Anterior Spinal Artery injury
    1. Corticospinal tract injury
    2. Spinothalamic Tract injury
      1. 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 (e.g. AAA repair)
  • Signs
  1. Motor weakness (below injury level)
  2. Pain and Temperature sense loss (below injury level)
    1. Proprioception and vibratory Sensation are spared
  • Management
  1. Physical Therapy and Occupational Therapy
    1. Rehabilitation of motor function
  • References
  1. Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
  2. Rodriguez, Winger, Poulo and Glunk (2023) Crit Dec Emerg Med 37(3): 23-9
  3. Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]