Anterior cord syndrome is a spinal injury. There are many types of injuries that can affect the spinal cord and cause Anterior Cord syndrome. The c spine, or cervical spine, could be impacted. Cord compression is a possible problem. With spinal cord compression patients might have symptoms such as myelopathy, including cervical myelopathy, or they could have a bulging disc in the neck. The spinal cord can be compressed anywhere in the cervical, thoracic, or lumbar regions. There are several causes of spinal cord compression and anterior cord syndrome, such as osteoarthritis, rheumatoid arthritis, tumor, bone diseases, spinal injury, infection, or abnormal alignment.1 Myelopathy means that neural signals are interrupted, due to inflammation, tumor, degeneration, trauma, viruses, or autoimmune disorders, for example. Some symptoms include numbness, weakness, stiffness, loss of balance, neck pain, or urinary troubles.2 Besides spinal compression, patients may present with a compression fracture, central cord syndrome, or anterior cord syndrome. Central cord syndrome is an acute injury that leads to motor functioning impairment (especially to the upper extremities), bladder dysfunction, and “sensory loss below the level of injury”.3 Automobile accidents cause most of the spinal cord injuries, and “males represent 81.2% of all reported SCIs”. Sports-related SCIs (spina cord injuries) typically affect people under 30, as younger people are more prone to push themselves harder for longer and sometimes forget to properly warm up and cool down. Anterior cord syndrome is due to injury to the anterior spinal cord. As a result, patients “feel some types of crude sensation” due to the posterior spinal cord, “but movement and more detailed sensation are lost”.4
About Anterior Cord Syndrome
Anterior cord syndrome is also known as anterior spinal artery syndrome and Beck’s syndrome. It is a spinal cord injury (SCI) that is “due to ischaemia/infarction of the anterior two-thirds of the spinal cord…sparing posterior third”. There are a few causes of anterior spinal injury, including aortic pathology, atherosclerosis, trauma (such as a stab injury), and external compression (such as from a herniated disc or posterior osteophyte). Patients with the disorder present with “complete motor paralysis below the level of the lesion”, as well as loss of temperature and pain below the injury level. They do have “intact 2-point discrimination, proprioception and vibratory senses”; however, there are autonomic, and likely bladder, bowel, and sexual dysfunctions. Anterior cord syndrome can occur as the result of trauma or non-trauma processes.5
Treating Anterior Cord Syndrome
Unfortunately, the prognosis for anterior cord syndrome is the “worst among all other spinal cord injury syndromes”. Usually the treatment focuses on supportive care and trying to treat the cause of the insufficiency.6 The outlook improves “if recovery is evident and progressive during the first 24 hours.”7 Typically, there is only a “10-20% chance of motor recovery”.8 Spinal cord injuries, in general, are often treated with a variety of modalities, such as physical therapy, occupational therapy, speech therapy, and recreational therapy. The goals are to improve range-of-motion and mobility, restore activities of daily living, and allow patients to return to areas of interest.9 In the case of any spinal injury, practitioners must take special care not to further the damage. With certain disorders, such as cervical spondylotic myelopathy (a spinal cord compression), there are non-surgical treatment options. Patients may wear soft collars or engage in exercises. They could also be prescribed NSAIDs or steroid medications.10
Inter-Disciplinary Help for Spinal Cord Injuries That Can Lead to Anterior Cord Syndrome
There are many professionals who work together to assist patients with spinal cord injuries. During the inpatient rehabilitation portion of care, there is an inter-disciplinary team at work. Team members should know about the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). It is necessary to make sure that those with SCIs do not end up with medical complications that impact their activities of daily living (ADLs) and mobility. Psychosocial impacts must also be addressed. Pain and injury is a stressful time for anyone, so patients need a way to relieve their stress and relax. Patients with SCIs are in need of medical services. They are vulnerable to deep vein thrombosis (DVT), pneumonia, and pressure ulcers. Some physicians may have training in SCI Medicine, but others gain rehabilitation knowledge through experience. Since trauma, falls, accidents, violence, and sports injuries could be the cause of the spinal cord injury, patients will need to be treated for those injuries, such as fractures, pneumothorax and other pulmonary concerns, gastrointestinal and urological issues, loss of consciousness, cardiovascular problems, and musculoskeletal problems. They may also have cognitive and emotional complications due to traumatic brain injury. Because of the many medical support services (laboratory, pharmacy, and radiology, for example), paralyzed patients have their treatment coordinated through case managers. Other people who work with the patients are rehabilitation nurses, who help patients “adapt to an altered lifestyle”, and occupational and physical therapists. They can help patients restore strength and work on daily activities. Exercise and good posture, as well as proper ergonomics, may help patients prevent further injury, such as respiratory complications, pressure sores, or overuse injuries. Psychosocial services, respiratory care, and medical nutrition are just a few of the additional recommended services for SCI patients.11
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