Blunt traumatic posterior cord syndrome

Abstract

Introduction: Posterior cord syndrome (PCS) is rare and insufficiently assessed in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Case presentation: A 39-year-old male was involved in a motorcycle collision and presented with paresthesia of the entire body, neck pain, subjective right arm weakness, and loss of position sense in all extremities. Imaging of the cervical spine revealed fractures of the upper cervical spine including a teardrop fracture and hangman fracture. Patient underwent anterior cervical interbody fusion and plating and halo orthosis. He ultimately regained near full function. Follow-up imaging clearly depicted the traumatic lesion to the level of the posterior spinal cord. Discussion: PCS is uncommon, but may be underdiagnosed. We would like to emphasize the importance of a full neurological exam in order to properly diagnose and manage patients with PCS. Our case is unique since we were able to anatomically delineate the focus of spinal cord injury to the posterior column on follow up MRI at 10 months. Therefore, a delayed MRI obtained sub-acutely may facilitate the anatomical diagnosis of PCS.