Anterior cord syndrome arises from damage to the spinothalamic and corticospinal pathways.
Occurs due to injury of the anterior spinal artery (ASA) affecting the anterior two-thirds of the spinal cord.
The anterior spinal artery (ASA) is the amalgamation of the vertebral arteries with co-lateral blood flow from several radicular arteries (the artery of Adamkiewicz is the most important of these!). This leaves multiple areas of the cord vulnerable to watershed ischemia.
This damage manifests as:
Loss of motor function (flaccid paralysis), pain and temperature/ sensation loss distal to the lesion.
***Only vibration, position, and tactile sensation are preserved (as posterior column remains intact).