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Clinical Features and Outcomes of Posterior Spinal Artery Infarctions - A Review
You-Jiang Tan1,2, Sarah Ming Li Tan1, Youhong Tan3
1Department of Neurology, National Neuroscience Institute, Singapore General Hospital Campus, Singapore.
Neurology India
|February 3, 2026
Summary
Posterior spinal artery infarctions (PSAIs) are rare stroke mimics. While most patients achieve ambulation, older age, trauma, and longer infarcts indicate poorer outcomes.
Area of Science:
- Neurology
- Vascular Neurology
- Spinal Cord Medicine
Background:
- Posterior spinal artery infarctions (PSAIs) are infrequently documented in medical literature.
- Clinical manifestations and patient outcomes associated with PSAIs remain poorly understood.
- There is a lack of established treatment guidelines for PSAIs.
Purpose of the Study:
- To delineate the characteristic features of posterior spinal artery infarctions.
- To identify prognostic factors influencing ambulatory outcomes in PSAI patients.
Main Methods:
- A comprehensive literature review was performed.
- Data were extracted from 33 studies published between January 1993 and June 2023.
- Forty cases of posterior spinal artery infarctions were analyzed.
Main Results:
- The median age of affected individuals was 55 years, with a slight male predominance.
- Cervical cord infarcts were most common (73%), often presenting with pain (46%) and hemiparesis/hemisensory deficits (41%).
- Most patients received treatment, primarily antiplatelet agents, and 82% could ambulate, though 29% required assistance.
Conclusions:
- Posterior spinal artery infarctions are uncommon neurological events that can resemble cerebral strokes.
- Key diagnostic indicators include preceding trauma, endovascular procedures, and associated pain.
- While prognosis is generally favorable for ambulation, advanced age, prior trauma, and extensive infarcts may predict poorer functional recovery.
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