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Clinical Features Of Spinal Cord Syndromes

  1. Complete lesion (transection)
    1. No motor or sensory function in the lowest sacral segments (S4-S5)/below the level of spinal cord injury in the absence of spinal shock.
    2. Patients may gain some root function about the level of injury - a phenomenon called root escape, because this damage to nerve roots is a peripheral nerve injury (& may be neuropraxia). And it should not be taken as potential return of spinal cord function.
    3. Prognosis is poor
  2. Incomplete lesion  
    1. Any evidence of neurological function (sensory or motor) distal to the level of injury.
    2. Documentation of sacral nerve root function (perianal sensation, rectal tone and flexion of great toe) may be the only sign of partially functioning spinal cord or incomplete lesion.
Central Cord Syndrome 
  1. It occurs due to damage of spinal cord near central canal area. Main causes are hyperextension trauma, Syringomyelia, tumor and anterior spinal artery ischemia.
  2. It is most frequency of incomplete cord syndromes and occurs most frequently in elderly people with underlying degenerative spondylosis.
  3. Dissociative motor weakness with arm weakness out of proportion to leg weakness.
  4. Sacral sensory sparing.
  5. Neurological improvement occurs in following order-return of lower extremity strength, return of bladder function, return of upper extremity strength, and return of intrinsic function of the land.
Anterior Cord Syndrome 
  1. Both spinothalmic & corticospinal tracts (located in the anterior aspect of spinal cord) are injured with preservation of dorsal columns
  2. Variable loss of pain and temperature sensation and motor functions with preservation of proprioception, vibration sense and deep pressure sensation.
Brown Sequard Syndrome
It consist of ipsilateral motor (corticospinal tract) and proprioception (posterior column) loss and contralateral pain & temperature (spinothalmic tract) sensory loss
Posterior Cord Syndrome
Posteriorly located dorsal column is injured with intact spinothalmic and corticospinal tracts.
Loss of position and vibratory sense below the level of injury.

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