Over the past few weeks our blogs have looked at spinal and back anatomy and the common causes of spinal cord injury. This blog looks at the types of spinal cord injury that can occur and provides a summary of the 6 clinical syndromes all of which present in a slightly different way.
A spinal cord injury can be sub-grouped by clinical presentation. There are 6 well known spinal cord injury syndromes. These are:
- Central Cord Syndrome
- Brown-Sequard Syndrome
- Anterior Cord Syndrome
- Posterior Cord Syndrome
- Conus Medullaris Syndrome
- Cauda Equina Syndrome
Most patients who sustain a spinal cord injury will require an initial period of rehabilitation in one of the specialist spinal injury treatment centres across the country prior to returning home. The clinical outcome and functional deficit experienced can vary and will depend on the severity and level of the spinal injury. This highlights the variable nature of spinal cord injury and how each injury is specific to the individual. Generally speaking the spinal cord injury syndromes present as follows:
- Central Cord Syndrome – typically characterised by motor impairment in the upper limbs more so than the lower limbs. There will also be the presence of bladder dysfunction, urinary retention and varying degrees of sensory loss below the level of the spinal cord lesion.
- Brown-Sequard Syndrome – damage to one side of the spinal cord that causes motor loss on the side of the injury together with loss of sensitivity to pain and temperature on the opposite side of the injury.
- Anterior Cord Syndrome – an injury that affects the anterior two thirds of the spinal cord while preserving the posterior columns. Typically characterised by complete paralysis with physical skin sensitivity and decreased sensitivity to pain below the level of the injury. There is usually poor muscle power and co-ordination. This type of injury can be associated with flexion injuries, direct damage by bone fragments or disc compression or vascular insufficiency produced by the occlusion of the anterior spinal artery.
- Posterior Cord Syndrome – resulting from a lesion within the posterior columns of the spinal cord resulting in loss of proprioceptive (sense of body position) and vibration sense below the level of the injury. There will be preservation of muscle strength, temperature and pain sensation. This syndrome has been linked to neck hyperextension injuries, posterior spinal artery occlusion, tumours, disc compression and vitamin D deficiency.
- Conus Medullaris Syndrome – an injury to the sacral spine and lumbar nerve roots within the spinal canal. This condition includes saddle numbness, bladder and bowel dysfunction and variable degrees of lower limb weakness. Trauma and tumours can be the cause of this condition.
- Cauda Equina Syndrome – although technically not part of the spinal cord, this is classified as one of the spinal cord clinical syndromes. This involves compression of the Cauda Equina (the nerve roots within the sacral spine) which if left untreated can cause permanent neurological and urological injuries. These commonly present as saddle and partial lower limb numbness, bladder and bowel dysfunction, sexual dysfunction and variable lower limb weakness.
The summary above shows variety of symptoms when dealing with spinal cord injuries. It is essential that an individual who has suffered such an injury accesses specialist medical and rehabilitative treatment as soon as possible to enable them to achieve the best possible outcome from what is a serious and life changing injury.
If you, or a member of your family, have been affected by any of the issues raised in this blog, or any of our other blogs, please contact one of our specialist back and spinal injury lawyers on firstname.lastname@example.org or call 020 7814 1200.
Read the first edition of our spinal injury blog series "Spinal Injury: an overview" here.