What is the primary concern with anterior spinal artery syndrome?

The primary concern with anterior spinal artery syndrome is the loss of pain and temperature sensation, which occurs due to the involvement of the spinothalamic tract that runs in the anterior part of the spinal cord. This condition results from ischemia or reduced blood flow to the anterior spinal artery, which supplies the anterior two-thirds of the spinal cord. As a result, patients typically experience a loss of pain and temperature sensations below the level of the injury, while proprioception and vibratory sense—carried by the posterior columns—are generally preserved as those pathways are not affected.

The loss of proprioception, although significant, is not the key concern related to this syndrome since proprioceptive pathways are spared in anterior spinal artery syndrome. Difficulty with bowel and bladder control can occur due to various spinal cord injuries, but it is not the primary characteristic feature of this particular syndrome. Multiple fractures in the cervical spine would be a trauma-related issue and do not directly describe the specific concerns arising from anterior spinal artery syndrome itself. Thus, the loss of pain and temperature sensation is the most directly affected function and the primary concern in this scenario.