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Spinal Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
An anterior cord syndrome results from direct mechanical compression of the anterior cord or obstruction of the anterior spinal artery. It affects the spinothalamic and corticospinal tracts, resulting in variable loss of motor function (corticospinal tracts) and impaired pain/temperature sensation (spinothalamic tracts). There is preservation of light touch, proprioception and vibration sense (dorsal columns).
Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Anterior spinal artery syndrome: Weakness below the level of the lesion.Flaccid/areflexic acutely, progressing to spastic weakness: Sensory loss below the level of the lesion.Loss of pain, temperature, light touch.Preserved discriminating touch, vibration, proprioception.
Spinal CordAnatomical and Physiological Features
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Anterior spinal artery syndrome occurs when there is critical ischaemia of the anterior two-thirds of the spinal cord which leads to (i) paraplegia as a result of damage to corticospinal and vestibulospinal tracts; (ii) loss of pain, pressure and deep touch mediated by the spinothalamic tract and (iii) the preservation of light touch, proprioception and vibration sense which are mediated by the intact posterior (dorsal) columns which are supplied by the posterior spinal arteries.
Feasibility, safety, and functional outcomes using the neurological controlled Hybrid Assistive Limb exoskeleton (HAL®) following acute incomplete and complete spinal cord injury – Results of 50 patients
Published in The Journal of Spinal Cord Medicine, 2023
Mirko Aach, Thomas Armin Schildhauer, Amrei Zieriacks, Oliver Jansen, Martin Weßling, Alexis Brinkemper, Dennis Grasmücke
Fifty patients with acute incomplete and complete SCI (14 females, 36 males) participated in this prospective study. All patients were in the acute phase of SCI. In all patients, the time interval between SCI and the onset of HAL® training was less than one year (mean time 117.98 ± 95.82 days; range 4–327 days). All patients were classified prior to training according to the American Spinal Injury Association Impairment Scale (AIS). SCI lesions were located between C4 and L4 (AIS A-D). Sixteen subjects suffered from tetraplegia, and 34 from paraplegia. Three patients were classified as AIS grade A with no motor sensory function in the sacral segments S4/S5, but with zones of partial preservation (ZPP) below the lesion level. 30 patients were categorized as AIS grade C. Seventeen patients were classified as AIS grade D. No subject was classified as AIS grade B. Thirty-nine of the subjects had suffered traumatic spinal cord injuries. In four patients, massively prolapsed intervertebral discs caused incomplete paraplegia and in one patient, an epidural abscess with spondylodiscitis caused the SCI. In one patient, intramedullary cavernoma, and in another patient, anterior spinal artery syndrome caused the spinal cord lesion. One patient suffered from tuberculosis with osteolysis of the vertebra T7-T10. In one patient, a tumor infiltrated the spinal canal, one patient suffered cervical spinal canal stenosis and cervical myelopathy and in one patient, ischemic myelopathy caused the spinal cord lesion. Mean age ± SD at the time of enrollment was 43.88 ± 15.0 years (range, 18–72 years).
Spinal cord involvement in COVID-19: A review
Published in The Journal of Spinal Cord Medicine, 2023
Ravindra Kumar Garg, Vimal Kumar Paliwal, Ankit Gupta
The spinal cord predominantly receives blood from three main arteries – the anterior spinal artery and two posterior spinal arteries. Reinforcement of blood supply comes from the ascending cervical arteries (branches of the thyrocervical trunk), radicular-medullary branches (branches of the aorta), and the artery of Adamkiewicz (a branch of the aorta) at the level of the lower thoracic or lumbar vertebra. The occlusion of the artery of Adamkiewicz can result in spinal cord ischemia in the thoracolumbar region. Predominantly, this infarction is caused by aortic disease, thoracolumbar surgery, sepsis, hypotension, and thromboembolic disorders. Therefore, we suggest that spinal cord infarction because of hypercoagulability can lead to myelopathy in patients with COVID-19.46,47
Paraplegia following transarterial chemoembolisation for hepatocellular carcinoma: a case report
Published in Acta Chirurgica Belgica, 2021
The risk of spinal cord injury associated with ICA intervention exists because the spinal cord artery originates from the proximal ICA. The spinal cord is supplied primarily by one anterior and two posterior spinal arteries, which are augmented by radicular arteries derived from spinal branches of cervical, intercostal, and lumbar arteries [9]. The anterior spinal artery (ASA) supplies blood to the anterior two-thirds of the cord, including the anterior horns of the grey matter, spinothalamic tracts, and corticospinal tracts, which primarily dominate the motor nuclei. The two posterior spinal arteries (PSA) supply the dorsal columns and the posterior horns, which mainly process sensory information [10]. Therefore, because of anatomy and neurological distribution, the embolic materials created as part of TACE may bring about an embolic event with possible serious manifestations, even though the blood supply network of the spinal cord encompasses multiple anastomoses.