The anterior cord syndrome results from damage to the corticospinal and spinothalamic pathways with preservation of posterior column function. This is manifest by loss of motor function and pain and temperature sensation distal to the lesion. Only vibration, position, and crude touch are preserved. This syndrome may occur following direct injury to the anterior spinal cord. Flexion of the cervical spine may result in cord contusion or bone injury with secondary cord injury. Alternatively, thrombosis of the anterior spinal artery can cause ischemic injury to the anterior cord.78 Immediate evaluation with computed tomography CT or magnetic resonance imaging MRI may reveal an extrinsic mass that is amenable to surgical decompression. The overall prognosis for recovery of function historically has been poor and remains so today.5
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