What is Anterior Cord Syndome?

What is Anterior Cord  Syndome?

Anterior cord syndrome is a severe form of incomplete spinal cord injury with the poorest prognosis among spinal cord syndromes, closely resembling a complete spinal cord injury.

Spinal Cord Injury Syndromes

Spinal Cord Injuries are normally classified into ‘complete’ or ‘incomplete’. A complete SCI refers to injuries where there is no muscle function or sensation below the level of injury. This affects both sides of the body to the same degree. A complete spinal cord injury does not necessarily mean the spinal cord has been severed. This rarely occurs. An incomplete SCI refers to injuries with some muscle function and sensation below the level of lesion or injury. There may be sensation but no movement in one limb or one side of the body, or there may be movement but no sensation.

Anterior Cord Syndromes

Then, a subset of SCIs is classified by their clinical presentation into 6 Spinal Cord Injury Syndromes: central cord syndrome (CCS), Brown-Sequard syndrome (BSS), anterior cord syndrome (ACS), conus medullaris syndrome (CMS), cauda equina syndrome (CES) and posterior cord syndrome (PCS).

Anterior Cord Syndrome occurs when the anterior spinal artery is compressed, depriving the spinal cord of oxygen and disrupting nerve signal transmission. As a result, individuals experience significant motor function loss, particularly in the lower body, along with impairments in temperature sensation, pain perception, and certain sensory functions. However, vibratory sense and proprioception typically remain intact.

The anterior part of the spinal cord is responsible for muscle control of the upper extremities and neck, as well as light touch sensation, while the posterior part transmits sensory impulses from the lower back, chest, and limbs. Damage to the anterior region can lead to severe functional deficits, including impaired voluntary motion, reduced position and movement awareness, diminished ability to differentiate between two points of contact, and decreased sensation of vibration, deep touch, and pressure. Some studies question the extent of deep pressure loss, but overall, the injury significantly affects mobility and daily functioning.

Given that the anterior spinal artery supplies two-thirds of the spinal cord, this area is particularly vulnerable in traumatic incidents, making anterior cord syndrome a common and devastating outcome. The condition not only imposes profound physical limitations but also takes a significant emotional toll, affecting independence and quality of life. While some individuals may regain function through rehabilitation, recovery is uncertain and often incomplete. If you or a loved one has suffered from anterior cord syndrome due to someone else’s negligence, securing the right legal and medical support is crucial. Our Hamilton spinal cord injury lawyers specialize in representing victims of complex spinal injuries, ensuring that their present and lifelong needs are met and fully compensated.

Symptoms of Anterior Cord Syndrome

Anterior cord syndrome generally consists of three main symptoms that could become impaired: motor, sensory, and reflex. It is considered an incomplete spinal cord injury, which means that the severity and loss of specific senses and functions may vary, and some sensations may remain intact. For example, an individual who experiences loss of motor function in the lower body may find that they are capable of moving one leg more than they can the other or that there is some sensation in one area but not another.

Due to the fact that the anterior spinal artery is the main supplier of blood to the spinal cord, anterior cord syndrome can result in loss of motor function and feeling in the lower body. This may occur to varying degrees of severity.

Sensory symptoms of anterior cord syndrome include loss of feeling of touch and loss of temperature in the area. While these sensory functions are often lost with this type of injury, it is also possible that the injured will experience vibrations or joint position sense in the affected area. Other symptoms may include bowel or bladder dysfunction, loss of libido, or sexual dysfunction. This can also be coupled with sudden pain or shock to surrounding areas such as the back or chest.

Individuals with anterior cord syndrome are still capable of vibration sense and proprioception (spatial awareness) because the dorsal column stays intact when the anterior spinal artery is impaired. The dorsal column is the part of the spine that includes function for those specific sensations.

How is Anterior Cord Syndrome caused?

The underlying cause of anterior cord syndrome is compression of the anterior spinal artery.

In some cases, anterior cord syndrome can occur without any signs of previous trauma in the individual’s body. For example, a herniated disc or a compression that occurs during spinal cord surgery could ultimately lead to anterior cord syndrome and loss of motor capabilities. It is also common for compression of the anterior spinal artery to occur from a traumatic injury such as a car accident, sports injury, or a hard slip and fall.

Generally, the timeline could come as either acute anterior cord syndrome or late anterior cord syndrome. Acute anterior cord syndrome occurs immediately or within a few hours of the initial injury or compression. This can manifest as spinal shock or back/chest pain that renders the individual incapable of utilizing motor functions below the spine. Late anterior cord syndrome occurs when these issues do not manifest for multiple days or weeks after the injury. For this reason, it may have a sudden impact when the symptoms begin to appear as the individual is not expecting this type of shock to the system and may not make the connection to the specific event that caused it.

Diagnosis

If anterior cord syndrome is suspected, a physician will generally issue a physical exam, followed by an x-ray or an MRI. The physical exam will determine which body parts have been affected and which senses or functions are still intact. These conclusions will then determine which treatment and diagnosis will be effective.

A spinal MRI is the most effective method of confirming anterior cord syndrome and will render the most conclusive results within the clinical setting. Since the MRI scan can provide more conclusive images of the spinal cord, this test will indicate damage that has occurred to the nerves.

What Treatments Are Available for Anterior Cord Syndrome?

With Anterior Cord Syndrome, there will be no improvement unless the SCI victim shows improvement in the first twenty-four hours. Most patients with Anterior Cord Syndrome usually have a complete loss of strength below the level of injury.

Treatment for an incomplete spinal cord injury varies depending on the severity and location of the injury. For anterior cord syndrome, this may include surgery, neurogenic shock management, or physical therapy.  Unfortunately, in most cases of spinal cord injury, complete recovery is unlikely. Further, anterior cord syndrome is considered one of the worst types of incomplete spinal cord injury in terms of prognosis and recovery. After 24 hours, if there is no progression or mobile function does not return, this indicates that the prognosis will have permanent limitations and effects. Generally, there is approximately a 10-24% change of recovery of mobility for the individual.

Upon immediate impact, an individual suffering from anterior cord syndrome may be brought into the hospital to undergo a spinal alignment in an attempt to alleviate the damage. This is done for acute anterior cord syndrome and is generally unsuccessful after more prolonged onset symptoms occur.

Doctors are more likely to perform surgery on an incomplete spinal cord injury than a complete one and may perform one for anterior cord syndrome. However, this mainly occurs when the individual has undergone compression due to a herniated disc or other internal lesion that has impacted the injury. While the process is not likely to provide a full recovery for the victim, it may offer relief for pain and prevention of further deformity through stabilization of the spine.

In addition to these treatments, the individual may benefit from physical therapy and assistive medical devices to ease their adjustment back into society and their daily life. Throughout this process, medications may be prescribed to provide relief from any chronic pain that the individual may feel.

If you’ve suffered a Spinal Cord Injury, our Hamilton Spinal Cord Injury Lawyers can help.

If you have suffered a spinal cord injury, our Hamilton personal injury lawyers can help. We have strong connections with reliable, trusted professionals in Ontario and can recommend the best specialists to assist you. From caregivers to life planners to negotiating with your insurance company, we can provide many services that go beyond legal advice and representation – such as protecting your financial future. Undoubtedly, you will need many items to assist your condition now and as you age. At Lalande Personal Injury Lawyers, we take pride in being trusted Hamilton personal injury lawyer ssince 2003. Over the years, we’ve helped our clients recover more than $45 Million in settlements and verdicts in personal injury, disability, and employment law cases. Whether you’re dealing with a life-changing injury, a denied disability claim, wrongful death, a hurt child or employment termination, we are here to provide compassionate and experienced legal representation. If you believe you have a case, call us today—we’re ready to help you secure the compensation you deserve. Call Lalande Personal Injury Lawyers today, no matter where you are in Ontario at 905-333-8888 for your free consultation. Alternatively, you can contact us online, confidentially, by filling out a contact form.