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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Anterior Cord Syndrome



- Discussion:
    - damage is primarily in the anterior 2/3 of cord, and is related to vascular insufficiency (see blood supply to the spinal cord);
    - there is sparing the posterior columns (position sense, proprioception, and vibratory sensation);
    - CT scans may demonstrate bony frags compressing anterior spinal cord;

- Clinical Findings:
    - syndrome is manifested by complete motor paralysis (corticospinal function) & sensory anesthesia (spinothalamic function);
    - there is sparing of the dorsal column:
           - deep pressure and proprioception are only retained sesibility of the trunk and lower extremities;
    - patient demonstrates greater motor loss in the legs than arms;

- Prognosis:
    - anterior cord syndrome has the worst prognosis of all cord syndromes;
    - prognosis is good if recovery is evident & progressive during first 24 hours;
    - after 24 hrs, if no signs of sacral sensibility to pinprick or temp are present, prognosis for further functional recovery are poor;
    - only 10 to 15% of patients demonstrate functional recovery



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, April 25, 2012 2:16 pm