Posterior Cord Syndrome

Posterior Spinal Artery Syndrome (PSAS) — also called Posterior Cord Syndrome — is a rare form of incomplete spinal cord injury that affects the posterior (dorsal) columns of the spinal cord. It often results in sensory loss, including vibration and position sense, which can lead to poor coordination, instability and walking difficulties.

At The Royal Buckinghamshire Hospital, we provide specialist inpatient rehabilitation for adults recovering from neurological and spinal cord injuries, including rare presentations such as Posterior Cord Syndrome. Our multidisciplinary team focuses on restoring function, balance and confidence in a highly supportive environment.

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What Happens In Posterior Cord Syndrome?

The posterior spinal arteries supply the back third of the spinal cord. When blood flow is interrupted — due to trauma, vascular disease, infection or surgery — the dorsal columns may become damaged. These tracts are essential for proprioception (body position sense), fine touch, and vibration.

Motor function and pain/temperature sensation are often preserved, but people experience significant issues with balance, coordination and spatial awareness.

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Common Causes

• Trauma (e.g. hyperextension injuries)
• Spinal cord compression (e.g. tumour, disc herniation)
• Vascular disorders (e.g. posterior spinal artery infarction)
• Multiple sclerosis or other demyelinating diseases
• Syphilis (tabes dorsalis), vitamin B12 deficiency or copper deficiency
• Post-operative spinal cord ischaemia

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Symptoms Of Posterior Cord Syndrome

Symptoms can vary by level of injury but may include:

• Poor balance, especially with eyes closed (positive Romberg’s sign)
• Loss of vibration and proprioception (joint position sense) below the lesion
• Clumsy or uncoordinated limb movements (sensory ataxia)
• Wide-based, unsteady gait
• Difficulty walking in the dark or on uneven surfaces
• Mild bladder or bowel dysfunction in some cases
• Muscle strength and pain/temperature sensation often preserved

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How It’s Diagnosed

Diagnosis is based on clinical examination and imaging:

• Neurological assessment identifying selective sensory deficits
• MRI spine to confirm spinal cord involvement and assess structural causes
• Blood tests to rule out vitamin deficiencies or autoimmune causes
• Vascular imaging (CTA/MRA) where infarction or vessel narrowing is suspected

At The Royal Buckinghamshire Hospital, patients typically arrive after diagnosis for post-acute functional rehabilitation.

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Rehabilitation At The Royal Buckinghamshire Hospital

We specialise in restoring movement, coordination and independence following spinal cord injuries, including PSAS:

Consultant-Led Neurological Rehabilitation

Care plans are led by a consultant in rehabilitation medicine with support from our full clinical team.

Physiotherapy

• Gait re-education using bars, hoists or robotic aids
• Balance and proprioceptive training
• Joint stability and core strengthening
• Visual feedback systems for coordination

Occupational Therapy

• Functional mobility and safety training
• Activities of daily living (e.g. dressing, transfers)
• Sensory re-integration therapy
• Home environment planning and equipment advice

Nursing & MDT Support

• 24/7 specialist neuro-trained nurses
• Skin integrity, continence and nutrition support
• Medication management and routine monitoring

Additional Services

• Neuropsychology to support adjustment, mood and cognitive changes
• Dietetics for nutritional support and B12/copper management
• Speech and Language Therapy if higher-level coordination or cognition is affected
• Access to a discharge coordinator for long-term care planning

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When To Refer Or Enquire

We accept adult patients (18+) with confirmed Posterior Cord Syndrome who are ready to begin active neurorehabilitation. Referral sources include:

• NHS discharges
• Private insurers
• Case managers and solicitors
• Self-referrals and family enquiries

Call 01296 678800 or enquire online for availability, admission guidance and funding support.

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Why Choose The Royal Buckinghamshire Hospital?

• Nationally recognised for neurological and spinal rehabilitation
• Skilled in rare and complex syndromes such as PSAS
• Intensive therapy programmes tailored to the individual
• Inpatient environment designed for neurological recovery
• All care delivered on one site, with full MDT support