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Abstract

This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case.

A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks.

Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.

Keywords

thoracic disc herniation ischemia artery of Adamkiewicz anterior spinal artery syndrome

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References

Satran

: Spinal cord infarction. Stroke 19: 529–532, 1988.

Rogers

Osler

: Isolated stab wound to the artery of Adamkiewicz: Case report and review of the literature [see comments]. J Trauma 43(3): 549–551, 1997.

Ebraheim

: Vulnerability of great medullary artery. Spine 21: 1852–1855, 1996.

Dommisse

: The blood supply of the spinal cord. A critical vascular zone in spinal surgery. J Bone Joint Surg [Br] 56: 225–235, 1974.

Boglino

Martins

: Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: An unusual catastrophic complication. Med Pediatr Oncol 32: 349–352, 1999.

Mawad

Rivera

: Spinal cord ischemia after resection of thoracoabdominal aortic aneurysms: MR findings in 24 patients. Am J Roentgenol 155: 1303–1307, 1990.

Mansour

Hammoud

Vlahovitch

: [Brown-Sequard syndrome caused by foramen and calcified disk herniation, responsible for direct compression of Adamkiewicz's artery]. Neurochirurgie 33: 478–481, 1987.

Moorhouse

Burke

: Spinal cord infarction caused by cartilage embolus to the anterior spinal artery. Surg Neurol 37: 448–452, 1992.

Terry

McSweeney

Jones

: Paraplegia as a sequela to dorsal disc prolapse. Paraplegia 19: 111–117, 1981.

10.

Elksnis

Hogg

Cunningham

: MR imaging of spontaneous spinal cord infarction. J Comput Assist Tomogr 15: 228–232, 1991.

11.

Sekhar

Jannetta

: Thoracic disc herniation: Operative approaches and results. Neurosurgery 12: 303–305, 1983.

12.

Stillerman

Chen

: Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg 88: 623–633, 1998.

13.

Alleyne

Jr Cawley

: Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery. J Neurosurg 89: 791–795, 1998.

14.

Rodriguez-Baeza

Muset-Lara

: The arterial supply of the human spinal cord: A new approach to the arteria radicularis magna of Adamkiewicz [see comments]. Acta Neurochir 109: 57–62, 1991.

15.

Fried

Di Chiro

Doppman

: Ligation of major thoraco-lumbar spinal cord arteries in monkeys. J Neurosurg 31: 608–614, 1969.

16.

Monteiro

Leite

: Spontaneous thoracolumbar spinal cord infarction: Report of six cases. Acta Neurol Scand 86: 563–566, 1992.

17.

Brown

: The natural history of thoracic disc herniation. Spine 17: S97–102, 1992.

Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome

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