Spinal Cord Injuries
| Type of Injury | Cause/ Mechanism | Clinical Features | Prognosis | Key Differentiation |
|---|---|---|---|---|
| Anterior Cord Syndrome | Flexion injury, occlusion of anterior spinal artery | - Loss of motor function below the lesion (corticospinal tract) - Loss of pain and temperature sensation (spinothalamic tract) - Preserved proprioception and vibration | Poor functional recovery due to motor and sensory loss | Motor and sensory loss with sparing of proprioception and vibration. |
| Posterior Cord Syndrome | Trauma, compression, or ischemia affecting posterior spinal arteries | - Loss of proprioception, vibration, and fine touch (dorsal columns) - Preserved motor, pain, and temperature functions | Varies depending on the extent of injury | Rare; primarily involves loss of proprioception and vibration sensation. |
| Brown-Séquard Syndrome | Hemisection of the spinal cord (e.g., penetrating trauma or tumor) | - Ipsilateral loss of motor function and proprioception below the lesion - Contralateral loss of pain and temperature below the lesion | Good prognosis, depending on extent of recovery | "Ipsilateral motor and sensory loss with contralateral pain and temperature loss" hallmark. |
| Complete Cord Injury | Severe trauma or transection of the spinal cord | - Complete loss of motor, sensory, and autonomic function below the level of injury | Poor functional recovery; often permanent | Total absence of motor, sensory, and reflex activity below the lesion. |
| Central Cord Syndrome | Hyperextension injury (e.g., fall), typically in older adults with cervical spondylosis | - Weakness more severe in upper limbs than lower limbs - Variable sensory loss - Bladder dysfunction (sometimes transient) | Good prognosis for functional recovery, especially in younger individuals | "Upper limb > lower limb weakness" hallmark; often bladder dysfunction. |
| Cauda Equina Syndrome | Compression of the cauda equina nerve roots (e.g., disc herniation, tumor, trauma) | - Asymmetric lower limb weakness - Saddle anesthesia - Bowel and bladder dysfunction - Loss of Achilles reflex | Variable recovery; early surgical decompression improves outcomes | Peripheral nerve injury; LMN signs with asymmetric weakness and sensory loss. |
| Root Injury | Damage to spinal nerve roots due to trauma, herniation, or inflammation | - Radicular pain in a dermatomal distribution - Sensory loss and motor weakness (in root's area of innervation) - Loss of reflexes | Generally good with treatment of the underlying cause (e.g., surgery, steroids, or conservative care) | Involves single or multiple nerve roots; follows a dermatomal and myotomal pattern. |
| Conus Medullaris Syndrome | Injury to the conus medullaris (lower end of the spinal cord) | - Bilateral lower limb weakness - Saddle anesthesia - Early bowel and bladder dysfunction - Hyperreflexia | Poor prognosis if delayed treatment; surgical decompression can improve outcomes | Mixed UMN and LMN signs; more symmetric presentation compared to cauda equina syndrome. |