S14.13

Clinical Causes: Traumatic injuries resulting from falls or vehicular accidents that cause compression or tearing of the anterior spinal artery or the front part of the cervical spinal cord. Neck trauma involving direct impact or flexion injuries that compromise blood flow or cause direct damage to the spinal cord tissue. Degenerative conditions, such as herniated discs or osteophytes, which can sometimes compress the anterior aspect of the spinal cord. Infections that lead to inflammation and damage in the cervical region of the spinal cord. Vascular issues, including ischemia of the anterior spinal artery due to embolism or thrombosis. Tumors or growths pressing on the cervical spinal cord from the front.

Key Symptoms: Motor weakness or paralysis below the level of injury, often affecting the legs and sometimes the arms. Loss of pain and temperature sensation, as these pathways are primarily located in the anterior portion of the spinal cord. Preservation of proprioception, vibration, and fine touch sensations, which are carried in the dorsal (back) columns. Sudden onset of symptoms following trauma or injury. Possible bowel and bladder dysfunction depending on the severity and level of the injury. Muscle spasticity or flaccidity may develop over time.

Diagnosis Path: Diagnosis involves a combination of clinical assessment and imaging studies. Magnetic resonance imaging (MRI) is the preferred modality, providing detailed images of the spinal cord to identify areas of injury, compression, or blood flow issues. Neurological examinations are conducted to evaluate motor, sensory, and reflex functions. Additional tests may include CT scans or myelography if necessary. MRI findings typically reveal anterior spinal cord damage, with preserved dorsal columns.

Treatment Protocols: Treatment strategies focus on stabilizing the spinal injury and preventing further deterioration. Immediate management includes immobilization of the neck and careful monitoring. Surgical intervention may be necessary to decompress the spinal cord or remove compressive structures. Supportive care includes physical therapy and rehabilitation to maximize functional recovery. Medications such as corticosteroids might be administered during the acute phase to reduce inflammation, though their use is subject to clinical judgement. Long-term management involves addressing complications like muscle weakness, spasticity, and autonomic dysfunction.