Posterior Cord Syndrome: Difference between revisions
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== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
As the name implies, the vast majority of damage with this form of incomplete spinal cord injury is towards the posterior aspects of the spinal cord. As a result, the common location of injury in Posterior Cord Syndrome is to the posterior columns and dorsal horns of the spinal cord, which are part of the [[Dorsal Column Medial Lemniscal Pathway]] (DCML). The DCML provides the sensory information of discriminative touch (two point discrimination, stereognosis, localization of touch), vibration, conscious proprioception, and information for combined cortical functions such as graphesthesia for all body regions except the head. The end destination of this information is then carried to the primary somatosensory cortex of the [[Parietal Lobe]] for central processing. | As the name implies, the vast majority of damage with this form of incomplete spinal cord injury is towards the posterior aspects of the spinal cord. As a result, the common location of injury in Posterior Cord Syndrome is to the posterior columns and dorsal horns of the spinal cord, which are part of the [[Dorsal Column Medial Lemniscal Pathway]] (DCML). The DCML provides the sensory information of discriminative touch (two point discrimination, stereognosis, localization of touch), deep touch, vibration, conscious proprioception, and information for combined cortical functions such as graphesthesia for all body regions except the head.<ref name=":0">Al-Chalabi M, Reddy V, Alsalman I. Neuroanatomy, Posterior Column (Dorsal Column). StatPearls [Internet]. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507888/ (accessed 31 January 2024).</ref> The end destination of this information is then carried to the primary somatosensory cortex of the [[Parietal Lobe]] for central processing.<ref name=":0" /> | ||
However, when considering the vascular [[Spinal cord anatomy|anatomy of the spinal cord]], specifically the posterior spinal arteries, there may be some alterations to the [[Corticospinal Tract]] or even aspects of the [[Spinothalamic tract]] due to a border zone of infusion. <ref>McKinley W, Hills A, Sima A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952058/ Posterior cord syndrome: Demographics and rehabilitation outcomes.] J Spinal Cord Med. 2021;44(2):241</ref>As there is generally not extensive damage to the corticospinal or spinothalamic tracts, voluntary motor function (corticospinal tract), and sensations of pain, crude touch, and temperature (spinothalamic tract) are preserved.<ref>Welniarz Q, Dusart I, Roze E. [https://pubmed.ncbi.nlm.nih.gov/27706924/ The corticospinal tract: Evolution, development, and human disorders.] Dev Neurobiol. 2017;77(7):810-829</ref> <ref>Waxman SG. Clinical Neuroanatomy 27th ed. New York: McGraw Hill, 2013.</ref> | However, when considering the vascular [[Spinal cord anatomy|anatomy of the spinal cord]], specifically the posterior spinal arteries, there may be some alterations to the [[Corticospinal Tract]] or even aspects of the [[Spinothalamic tract]] due to a border zone of infusion. <ref>McKinley W, Hills A, Sima A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952058/ Posterior cord syndrome: Demographics and rehabilitation outcomes.] J Spinal Cord Med. 2021;44(2):241</ref>As there is generally not extensive damage to the corticospinal or spinothalamic tracts, voluntary motor function (corticospinal tract), and sensations of pain, crude touch, and temperature (spinothalamic tract) are preserved.<ref>Welniarz Q, Dusart I, Roze E. [https://pubmed.ncbi.nlm.nih.gov/27706924/ The corticospinal tract: Evolution, development, and human disorders.] Dev Neurobiol. 2017;77(7):810-829</ref> <ref>Waxman SG. Clinical Neuroanatomy 27th ed. New York: McGraw Hill, 2013.</ref> | ||
Revision as of 20:16, 31 January 2024
Introduction[edit | edit source]
Posterior Cord Syndrome is the rarest form of incomplete spinal cord injury. An individual with this form of spinal cord injury (SCI) will have intact motor function and sensations of pain, light touch, and temperature, but impairments in proprioception, vibration, kinesthesia, and combined cortical functions below the level of the lesion (see: Sensation).
Clinically Relevant Anatomy[edit | edit source]
As the name implies, the vast majority of damage with this form of incomplete spinal cord injury is towards the posterior aspects of the spinal cord. As a result, the common location of injury in Posterior Cord Syndrome is to the posterior columns and dorsal horns of the spinal cord, which are part of the Dorsal Column Medial Lemniscal Pathway (DCML). The DCML provides the sensory information of discriminative touch (two point discrimination, stereognosis, localization of touch), deep touch, vibration, conscious proprioception, and information for combined cortical functions such as graphesthesia for all body regions except the head.[1] The end destination of this information is then carried to the primary somatosensory cortex of the Parietal Lobe for central processing.[1]
However, when considering the vascular anatomy of the spinal cord, specifically the posterior spinal arteries, there may be some alterations to the Corticospinal Tract or even aspects of the Spinothalamic tract due to a border zone of infusion. [2]As there is generally not extensive damage to the corticospinal or spinothalamic tracts, voluntary motor function (corticospinal tract), and sensations of pain, crude touch, and temperature (spinothalamic tract) are preserved.[3] [4]
Pathophysiology[edit | edit source]
add text here relating to the mechanism of injury and/or pathology of the condition
Etiology[edit | edit source]
Epidemiology[edit | edit source]
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
For a comprehensive clinical examination overview, see: Assessment of Spinal Cord Injury
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Differential Diagnosis[edit | edit source]
add text here relating to the differential diagnosis of this condition
Management / Interventions[edit | edit source]
add text here relating to management approaches to the condition
Prognosis[edit | edit source]
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
American Spinal Injury Association (ASIA) Impairment Scale
Spinal Cord Injury Outcome Measures Overview
Resources
[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ 1.0 1.1 Al-Chalabi M, Reddy V, Alsalman I. Neuroanatomy, Posterior Column (Dorsal Column). StatPearls [Internet]. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507888/ (accessed 31 January 2024).
- ↑ McKinley W, Hills A, Sima A. Posterior cord syndrome: Demographics and rehabilitation outcomes. J Spinal Cord Med. 2021;44(2):241
- ↑ Welniarz Q, Dusart I, Roze E. The corticospinal tract: Evolution, development, and human disorders. Dev Neurobiol. 2017;77(7):810-829
- ↑ Waxman SG. Clinical Neuroanatomy 27th ed. New York: McGraw Hill, 2013.
