**Core Concept**
Posterior column lesions involve damage to the posterior columns of the spinal cord, which are responsible for transmitting sensory information from the body to the brain, including proprioception, vibration sense, and fine touch. This type of lesion can result in a range of symptoms, including loss of proprioception, difficulty with balance and coordination, and impaired fine motor skills.

**Why the Correct Answer is Right**
The posterior columns of the spinal cord contain the fasciculus gracilis and fasciculus cuneatus, which transmit sensory information from the body to the brain. The fasciculus gracilis is responsible for transmitting information from the lower body, while the fasciculus cuneatus is responsible for transmitting information from the upper body. The posterior columns do not transmit pain or temperature sensation, which are mediated by the spinothalamic tracts. Therefore, posterior column lesions do not affect pain or temperature sensation.

**Why Each Wrong Option is Incorrect**
**Option A:** Proprioception is affected in posterior column lesions because the posterior columns transmit proprioceptive information from the body to the brain. **Option B:** Fine touch is also affected in posterior column lesions because the posterior columns transmit fine touch information from the body to the brain. **Option D:** Vibration sense is affected in posterior column lesions because the posterior columns transmit vibration sense information from the body to the brain.

**Clinical Pearl / High-Yield Fact**
Posterior column lesions can result in a range of symptoms, including loss of proprioception, difficulty with balance and coordination, and impaired fine motor skills. It's essential to differentiate posterior column lesions from other types of spinal cord lesions, such as those affecting the spinothalamic tracts, which can result in pain and temperature sensation deficits.

**Correct Answer:** D. Pain and temperature sensation are unaffected in posterior column lesions.