Spinal Cord Syndromes

Basics

Complete cord syndrome:
- Total loss of sensory, autonomic, and voluntary motor innervation distal to the spinal cord level of injury
- Usually caused by trauma, but other causes include infarction, hemorrhage, and extrinsic compression
- Symptoms that remain >24 hr are generally permanent
Incomplete spinal cord lesions:
- Characterized by preservation of some spinal cord function
- 3 major types: Central cord syndrome, Brown-Séquard, and anterior cord syndrome
Central cord syndrome:
- Most common of the incomplete spinal cord syndromes
- Classically occurs in elderly patients, with pre-existing cervical stenosis, who suffer a hyperextension injury in a fall
Anterior cord syndrome:
- Most commonly associated with occlusion of the anterior spinal artery which can occur after aortic surgery or trauma. Other causes include hypotension and infection
Brown-Séquard syndrome:
- Hemisection of the spinal cord, classically as a result of a penetrating injury
- Rarely unilateral cord compression
Conus medullaris syndrome:
- Injury at the level of L1 or L2
- Causes include central disc herniation, neoplasm, and direct trauma
Cauda equina syndrome:
- Injury to the nerve roots of the cauda equine and not the spinal cord itself
- Causes include central disc herniation and direct trauma
- Clinically, can resemble conus medullaris syndrome

Spinal cord syndromes result from localized disruption of neurotransmission and exhibit mixed motor and sensory deficits. The most common mechanism is trauma
Patients with arthritis, osteoporosis, metastatic disease, or other chronic spinal disorders are at risk of developing spinal injuries as the result of minor trauma

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