From the Research
Posterior cord syndrome is a rare spinal cord injury that requires prompt diagnosis and treatment to improve outcomes, with the most recent and highest quality study suggesting that rehabilitation focusing on proprioceptive training and compensatory strategies can lead to significant functional improvements 1.
Key Findings
- The primary findings of posterior cord syndrome include loss of proprioception, loss of vibration sense, and impaired discriminative touch while preserving pain, temperature sensation, and motor function.
- Patients typically present with sensory ataxia, an unsteady gait that worsens when visual input is removed, and pseudoathetosis.
- The most common causes include dorsal column compression from tumors, vitamin B12 deficiency, tabes dorsalis, multiple sclerosis, and trauma to the posterior aspect of the spinal cord.
Diagnosis and Treatment
- Diagnosis is based on clinical examination demonstrating the characteristic sensory deficits with preserved motor function, and confirmed with MRI showing damage to the posterior columns.
- Treatment depends on the underlying cause, with options including surgical decompression for tumors, vitamin B12 supplementation for deficiency, antibiotics for infectious causes, and rehabilitation focusing on proprioceptive training and compensatory strategies.
- Rehabilitation outcomes can be improved with a focus on proprioceptive training and compensatory strategies, with a study showing significant improvements in functional independence and mobility in patients with posterior cord syndrome 1.
Prognosis
- Prognosis varies based on the cause, with better outcomes when the underlying condition is treatable and intervention occurs early.
- Patients often need to rely more on visual cues for movement and balance, and may benefit from assistive devices to prevent falls.
- The use of methylprednisolone in the treatment of acute spinal cord injury, including posterior cord syndrome, has been shown to improve neurologic outcome if administered within eight hours of injury, but its effectiveness is still a topic of debate 2.