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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