title: Paraplegia with lumbar artery compression by the diaphragmatic crus.
abstract: The authors report three cases of transient and recurrent paraplegia due to compression of the second right lumbar artery by the diaphragmatic crus. Circumstances of appearance are suggestive when paraplegia occurs in dorsolumbar hyperlordosis and low cardiac output is an associated hemodynamic risk factor. Selective medullary arteriography is indispensable for diagnosis and can demonstrate three signs: an anterior spinal dorsolumbar artery (artery of Adamkiewicz) that does not descend to the conus medullaris; posterior spinal arteries arising from the second lumbar arteries that vascularize the conus medullaris; existence of a tight stenosis on the second right lumbar artery that is aggravated during dynamic maneuvers. Section of the right diaphragmatic crus and release of the second right lumbar artery from the aorta to the fibrous arcade of the psoas permits definitive cure of symptoms.
authors.affiliation: Department of Vascular Surgery, Hôpital Saint-Roch, Université de Nice-Sophia Antipolis, Nice, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Batt
authors.forename: André
authors.initials: A
authors.lastname: Rogopoulos
authors.forename: Daniel
authors.initials: D
authors.lastname: Benchimol
authors.forename: René
authors.initials: R
authors.lastname: Chapot
authors.forename: Elixène
authors.initials: E
authors.lastname: Jean-Baptiste
authors.forename: Patrick
authors.initials: P
authors.lastname: Baque
mesh_terms: D000328:Adult; D003964:Diaphragm / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology*; D020760:Spinal Cord Ischemia / Q000150:complications*