Complete spinal cord transection syndrome

Background

Spinal cord tracts

Clinical Features

• Higher lesions are a/w spinal shock and autonomic dysfunction
• Priapism implies a complete injury
• Sacral sparing excludes complete transection
  • Can only be assessed AFTER spinal shock has ended, ie after return or bulbocavernosus/cremasteric reflexes
  • Sacral sparing manifests as intact great toe flexor function, perianal sensation, rectal motor function

Differential Diagnosis

Spinal Cord Syndromes

• Complete spinal cord transection syndrome
• Anterior cord syndrome
• Central cord syndrome
• Brown-Séquard syndrome
• Epidural compression syndromes
  • Spinal cord compression (non-traumatic)
  • Cauda equina syndrome
  • Conus medullaris syndrome
  • Epidural abscess (spinal)
  • Epidural hematoma (spinal)