In anterior spinal artery syndrome which of the following is spared
The anterior spinal artery supplies the anterior two-thirds of the spinal cord. That includes the anterior horns (which contain motor neurons), the lateral and medial motor columns, and the spinothalamic tract in the anterior part. The posterior one-third is supplied by the posterior spinal arteries. So, the posterior columns (dorsal columns) are fed by the posterior arteries.
In anterior spinal artery syndrome, the main deficits would be motor function (since anterior horns are affected) and loss of pain and temperature (spinothalamic tract). But the posterior columns, which handle proprioception and vibration sense, should be spared. So the correct answer should be the one mentioning preservation of proprioception or vibration.
Now, looking at the options (though they're not provided here), the correct answer would be something like "proprioception" or "dorsal columns intact." The wrong options might include things like motor function (which is lost), pain (lost), or temperature (lost).
For the clinical pearl, it's important to remember that the key spared function is proprioception due to the posterior columns being supplied by the posterior spinal arteries. So the student should remember that the anterior two-thirds are affected, leaving the posterior one-third (dorsal columns) intact. That's the key point.
**Core Concept**
Anterior spinal artery syndrome involves ischemia of the anterior two-thirds of the spinal cord, primarily affecting motor pathways and spinothalamic tracts. The posterior columns remain intact due to separate posterior spinal artery supply.
**Why the Correct Answer is Right**
The posterior columns (dorsal columns) are supplied by the posterior spinal arteries, which are unaffected in anterior spinal artery syndrome. These columns mediate proprioception, vibration sense, and fine touch—functions preserved in this condition. The anterior artery supplies the corticospinal tracts (motor), spinothalamic tracts (pain/temperature), and anterior horn cells.
**Why Each Wrong Option is Incorrect**
**Option A:** Loss of motor function is incorrect—motor deficits are hallmark features due to corticospinal tract and anterior horn cell damage.
**Option B:** Absent pain and temperature sensation is incorrect—these are lost via spinothalamic tract ischemia.
**Option C:** Paralysis of lower limbs is incorrect—this occurs due to motor pathway involvement.
**Clinical Pearl / High-Yield Fact**
Remember the "3 A’s" of anterior spinal artery syndrome: **A**nterior cord involvement, **A**bsent motor function/pain/temperature, and **A**nterior horn cell damage. Proprioception (posterior columns) is **spared**, distinguishing it from posterior spinal artery syndrome.
**Correct Answer: D. Proprioception is preserved**