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 compelte cpinal cord injury does not necessarily mean the spinal cord has been severed. This in fact rarely occurs. An incomplete SCI refers to injuries where there is some muscle function and sensation below the level of lesion or injury. There may be sensation but not movement in one limb or one side of the body or there may be movement but no sensation.
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 is a type of incomplete spinal cord injury that can result in the loss of motor function or paralysis of the lower body. Generally, this type of spinal cord injury is classified by the individual’s loss of motor, temperature, and sensory functions while vibratory sense and proprioception remain intact.
As with any type of spinal cord injury, anterior cord syndrome can be devastating for the victim. The loss of motor function and other senses in the lower body can place significant limitations on an individual’s physical abilities as well as their sense of self worth and independence. In turn, almost all victims undergo significant emotional stress and crippling physical pain.If you or a loved one are suffering through the consequences of anterior cord syndrome, the right resources and information are vital for recovery. While the chances of regaining lost function are possible with anterior cord syndrome, this does not always occur, and the most important thing one can do is receive the right support during this difficult time. Our Hamilton spinal cord injury lawyers specialize in representing victims with complex injuries – including victims that have suffered complete or incomplete spinal cord injury. We are able to ensure that your projected needs, both presently and life-long are met and paid for, if you have been injured by someone else.
Anterior Cord Syndrome is the worst of all the spinal cord syndromes. It has the worst prognosis of any of the spinal cord syndromes. It is the syndrome closest to having a complete spinal cord injury. Anterior cord syndrome occurs when the anterior spinal artery is compressed and blood supply of oxygen can no longer reach the area. As a result, the body is incapable of sending nerve signals to the area and the spinal cord cannot fully function at its regular capacity.
The anterior part of the spinal cord carries the sense of light touch and the muscle control for the upper extremities and the neck. The posterior (back) part of the spinal cord carries sensory impulses from the sacral, lumbar, upper thoracic, lower thoracic areas of the body and the upper extremities. More simply, from the very low back, the low back, and the upper and lower chest. Damage to this part of the spinal cord causes an absence or decrease of the sense of position and movement, a loss of the ability to tell the difference between being touched in two different places (two-point discrimination), a loss of the ability to sense vibration, and a loss of the ability to sense deep touch and pressure; although the latter is questionable in some studies. Damage to this part of the spinal cord also interrupts impulses for voluntary motion and pain and temperature sensation.
The anterior spinal artery is the most common location for an incomplete spinal cord injury to occur due to the fact that it comprises two-thirds of the spinal cord. Thus, it is the largest part of the spinal cord, which makes it a target in many types of accidents and situations where injury could occur.
Two main factors are present with Anterior Cord Syndrome:
1) direct damage to the anterior part of the spinal cord by a dislocated bone fragment or herniated disk, and
2) disruption of the blood supply to the anterior spinal artery.
Anterior cord syndrome generally consists of three main types of 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, as well as 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 (an individual’s spatial awareness) due to the fact that 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.
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 resulting from an accident 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 as to the specific event that caused it.
If anterior cord syndrome is suspected, a physician will generally issue a physical exam, followed by either an x-ray or an MRI. The physical exam will determine which parts of the body have been affected and which senses or functions are still intact. These conclusions will then determine which type of 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. Due to the fact that the MRI scan can provide more conclusive images of the spinal cord, this test will indicate damage that has occurred to the nerves.
With Anterior Cord Syndrome, unless the SCI victim shows improvement in the first twenty-four hours, there will be no improvement. Most patients with Anterior Cord Syndrome usually have 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 affects. 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 longer onset symptoms occur.
Doctors are more likely to perform a surgery on an incomplete spinal cord injury than a complete one, and may perform one for anterior cord syndrome. However, this mostly 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 the use of assistive medical devices that may ease their adjustment back into society and their regular daily life. Throughout this process, medications may be prescribed in order to provide relief from any chronic pain that the individual may feel.
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 are able to provide many services that go above and beyond simply legal advice and representation – such as protecting your financial future. There’s no doubt that you will need a myriad of items to assist your condition now and as you age. Out Hamilton Spinal Cord Injury Lawyers, along with the appropriate life care planners, can ensure to calculate and project a clear, concise, and sensible presentation of your complex requirements to asssit with your present and future medical needs. Call us no matter where you are in Ontario at 1-844-LALANDE (525-2633) of local in the Hamilton / Burlington / Niagara areas at 905-333-8888 or, alternatively, send us a confidential message through our online contact form to set up a free, no-obligation consultation. And remember, we will never ask for money upfront.
*This information has been obtained from our experience and knowledge of spinal cord injury law as well as Medical Peer Reviewed Journals and Medical Studies from SCIRE (Spinal Cord Injury Research Evidence)