Abstract
Purpose: We encountered a case in which a sensory ataxia with difficulty in compensation for the dissociation of posterior column impairment and visual information was observed after the surgical removal of an intramedullary spinal cord tumor.
Case: The case involves a 58-year-old male who underwent surgery for an intramedullary tumor in the first cervical spinal cord.
Progress: Postoperatively, neurological examination revealed severe vibratory sense deficits in both lower limbs, marked hypoesthesia of superficial sensation, and neurogenic symptoms of numbness. Position sense of the big toe was normal, indicating dissociation in posterior column impairment. The toe-finger test was positive and walking decreased gait speed due to confirmation of the ground underfoot through vision and an extension of the stance phase in both legs. On the 4th postoperative day, treadmill walking commenced, demonstrating immediate improvement in confirming the ground underfoot through vision and extending the stance phase, improving walking speed.
Results: On postoperative day 15, the patient was discharged home. At the time of discharge home, he was evaluated for posterior spinal cord injury and a positive the toe-finger test, but he was able to move outdoors independently.
Conclusion: Recognizing the dissociation in posterior column function impairment, evaluating the posterior column through multiple assessments considering its functional stratification is imperative.
