Fibrocartilaginous emboli to the spinal cord: a review of the literature.
Fibrocartilaginous emboli to spinal cord vessels is an apparently rare cause of spinal cord injury. A review of the medical literature reveals only 24 reported cases, none of which were noted prior to 1961. The authors have reviewed an additional, but as yet unpublished, case. The majority of patients presented with the acute onset of pain located around the vertebral column which was followed by progressive paresis/paralysis and respiratory insufficiency. Minor trauma to the vertebrae prior to onset was noted in most cases. The time to maximum neurologic deficit (typically paraplegia or quadriplegia) ranged from minutes to 24 to 48 hours. In all but one case the spinal cord injury resulted in death within 11 months of onset with a median of 2.5 to 4 months. One patient lived six years and seven months with respiratory support. In yet another case, a fibrocartilaginous embolus to a sacral nerve root was found as an incidental finding at autopsy. The incidence of both asymptomatic and clinically significant emboli may be more common and depends on the awareness of the medical community to consider this in the differential diagnosis of spinal cord injury.
Department of Physical Medicine and Rehabilitation, New Jersey Medical School-UMDNJ, Newark.
W L
WL
Bockenek
J R
JR
Bach
D002356:Cartilage / Q000473:pathology; D003937:Diagnosis, Differential; D004617:Embolism / Q000150:complications* / Q000473:pathology; D006801:Humans; D011782:Quadriplegia / Q000150:complications*; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy