The anterior cord syndrome
– Complete paralysis below the level of the lesion due to interruption of the corticospinal tract
– Loss of pain and temperature sensation at and below the level of the lesion due to interruption of the spinothalamic tract
– Retained proprioception and vibratory sensation due to intact dorsal columns
– Areflexia, flaccid anal sphincter, urinary retention and ileus
Causes:
– spinal cord infarct secondary to occlusion of the arterial branches that supply the anterior spinal artery – aortic aneurysm / dissection, direct trauma to the aorta, aortic surgery, arteritis, arterial emboli / decompression sickness, direct vascular injury (trauma or iatrogenic), polycythemia, sickle cell disease, decompression sickness, cocaine use, collagen and elastin disorders
– trauma or acute disc herniation
– malignancy + anterior cord compression
Immediate complications:
– respiratory distress – respiratory failure
– spinal shock due to loss of the sympathetic tone if level is above T4