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A Boring guide to Spinal Cord Syndromes

Despite the fact that spinal cord syndromes can be difficult to remember, they are important to recognize and can yield a significant amount of clinical information. We seek to break spinal cord syndromes into an easy to digest and understand discussion.

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 Back to Basics: Incomplete Spinal Cord Syndromes

Review of the three most common presentations... Anterior, Central and Brown Séquard Syndrome.

 Today's pearl - Spinal Cord Syndromes

Spinal cord syndromes are usually the result of conditions extrinsic to the spinal cord, such as: compression due to spinal stenosis, herniated disc, tumor, abscess, and trauma (i.e. hematoma, retropulsion of bony fragments, bullet/knife injury). Less commonly, disorders intrinsic to the cord, such spinal cord infarction or hemorrhage, transverse myelitis, viral infection (HIV, polio, West Nile), syphilis, vitamin/mineral deficiency (B12, copper), decompression sickness, lightning injury, radiation therapy, syrinx, and neoplasms can also lead to the characteristic syndromes

Articles of Interest

Bored of the Cord: Spinal Cord Syndromes

Check out some totally gnarly cord syndromes in this episode of Bored Review!

Classifying incomplete spinal cord injury syndromes:

We developed a set of algorithms to assist the classification of SCI patients according to syndrome. At the outset it was necessary to make some assumptions about the syndromes. First, it was assumed that only one area of neurological damage was responsible for the pattern of sensory and motor loss.

Important spinal cord injury syndromes

Motor signs of anterior spinal cord syndrome are: Early flaccid paralysis, Incontinence, Bilaterally absent deep tendon reflexes, Later, spasticity and hyper-reflexia.

Spinal Cord Anatomy and Syndromes

Diagrams of the common syndromes.

Spinal Cord Injury Classification and Syndromes

Classifying the type and grading the severity of a traumatic or non-traumatic spinal cord injury is a universal language spine specialists speak that can improve patient communication.

What Is an Incomplete Spinal Cord Injury? (Symptoms + Prognosis)

Where a complete SCI fully severs the spinal cord at the site of the injury, an incomplete spinal cord injury only partially severs the spinal cord therefore allowing some signals to pass through the level of injury.

Resources

Anterior Cord Syndrome

ASAS is an incomplete spinal cord injury (SCI) that is often related to flexion injuries of the cervical region that result in infarction of the anterior two thirds of the cord and/or its vascular supply from the anterior spinal artery[2]. They present with impairments in the pain and temperature sensations while the vibratory and proprioceptive sensations are preserved. Motor deficits are observable both at and below the level of injury.

Brown Séquard Syndrome

Brown-Sequard Syndrome (BSS), an incomplete spinal cord injury, is a neurological condition that results from a hemisection to the spinal cord on either side, typically in the cervical and thoracic spinal cord region. This lesion leads to interruption of normal function of nerve tracts in one half of the spinal cord.

Cauda Equina Syndrome

CES is a topical issue, it can have a devastating effect on quality of life, place a significant burden on medical services and have considerable medico-legal implications arising from the perceived ramification of delays - Gavin Heyes

Central Cord Syndrome

CCS is a cervical spinal cord injury that causes motor weakness more prominent in the upper extremities than lower, a mixed sensory impairment below the level of the lesion, and bladder dysfunction. Because of its mixed distribution of sensory impairment, CCS can be described as being a “man in a barrel” or having “cape-like” sensory loss

Posterior Cord Syndrome

Posterior cord syndrome is a rare type of incomplete spinal cord injury that affects the dorsal columns of the spinal cord (found in the posterior—or backside—region of the spinal cord), responsible for the perception of fine-touch, vibration, sense of self-movement, and body positioning (proprioception).

Tethered Cord Syndrome

Tethered cord syndrome is a stretch-induced functional disorder associated with the fixation (tethering) effect of inelastic tissue on the caudal spinal cord, limiting its movement... Adult onset of tethered cord syndrome was considered to be rare for many years, but an increasing number of cases have been reported in recent years.