Anterior Cord Syndrome

　　The main cause of the disease is the formation of a thrombus in the anterior spinal artery. In young patients, it is often related to infection, and viral and bacterial toxins can cause damage to the vessel wall, leading to thrombosis. Conditions such as acute purulent meningitis, tuberculous meningitis, spinal vascular malformation, nodular perivascularitis, and syphilis infection can all be associated with this disease. In elderly patients, it is often due to atherosclerosis of the spinal arteries. The occlusion of the anterior spinal artery caused by bacterial endocarditis, syphilitic angiitis, or cholesterol embolism is less common. Spondylolysis and cervical hyperextension can also be associated with this disease.

　　The complications of the anterior spinal syndrome are mainly due to factors such as the inconvenience of the patient's movement, long-term bed rest and lack of exercise, and decreased immunity. The main complications include bedsores, atelectasis, and cystitis, among others.

　　According to the different clinical manifestations of this condition, it can be divided into four types: upper cervical, lower cervical, thoracic, and lumbar-sacral. The main clinical characteristics of this disease are mainly as follows:

　　1. Sudden onset of symptoms, with signs appearing rapidly.

　　2. The initial symptoms are mainly neurological root stimulation symptoms; root pain or numbness indicates the upper boundary of the lesion, and the common lesion area is mostly in the cervical or thoracic spinal cord, followed by the lumbar segment, and it is less common in the medulla.

　　3. The distribution area of the anterior spinal artery is damaged, showing motor dysfunction, such as paralysis or paraplegia of the limbs; dissociative sensory disorders, such as pain and temperature sensation disorders while tactile sensation remains normal; and sphincter dysfunction, such as rectal and bladder sphincter disorders, which may lead to urinary retention and other symptoms.

　　The focus of the prevention of anterior cord syndrome is to prevent primary diseases such as infection and atherosclerosis. Patients who are bedridden during delivery and have difficulty moving should pay attention to preventing complications such as decubitus ulcers, atelectasis, and cystitis.

　　The routine examinations for this disease include the following several items:
　　1. Cerebrospinal fluid examination: In this disease, lumbar puncture of the spinal canal is generally not obstructed, and the appearance of CSF is colorless and transparent or yellow, the cell count is normal, and sometimes the protein content is normal or slightly increased, and the cell count is mostly normal.
　　2. Other selective examination items include: blood electrolytes, blood glucose, blood urea nitrogen, and cancer胚抗原 tests.
　　3. MRI manifestations: In the acute phase, the spinal cord is thickened and swollen, T1WI shows low signal, T2WI shows high signal, the focus is significantly enhanced within 1-3 weeks of onset, and in the chronic phase, it can be manifested as spinal cord atrophy.

　　Anterior cord syndrome can cause abnormal urination and defecation in patients with spinal cord compression. Clinical diet should pay attention to the following:
　　1. Fruits, vegetables, beans, brown rice, and whole wheat are rich in fiber. Eating more of these foods makes stools soft and easy to pass, reducing the need for stool softeners.
　　2. Drink enough 3000 milliliters of water every day, which helps spinal cord injury patients empty their bladder at regular intervals, maintain cleanliness, and prevent urinary tract infections, and also helps make stools soft. The water quality must be clean; if it is not clean, it should be boiled for 20 minutes, cooled, and then drunk.
　　3. Spinal cord injury patients can drink a moderate amount of tea, coffee, or juice as an alternative to some water.
　

　　The measures for this disease are not the same due to different etiologies. If it is related to inflammation, antibiotics or antiviral preparations can be used. Hormones such as dexamethasone or hydrocortisone (hydrocortisone) have the effect of improving inflammation, reducing edema, and protecting nerve cell tissue. Medications to improve circulation and promote nerve metabolism can also be applied. In addition, early prevention and treatment of complications such as decubitus ulcers, atelectasis, and cystitis should be paid attention to.