Anterior disco-osteo-arterial conflict as a cause of intersegmental arterial flow impairment and spinal cord ischemia.
BACKGROUND
This article describes anterior disco-osteo-arterial conflict as an insofar unsuspected mechanism of arterial flow impairment potentially leading to spinal cord ischemia and infarction.


METHODS
The anterior disco-osteo-arterial conflict described in this report is illustrated with angiographic observations of patients presenting with spinal cord ischemia documented by MRI, and radiculomedullary flow impairment diagnosed by spinal digital subtraction angiography and spinal CTA.


RESULTS
Proximal intersegmental artery flow impairment was found in association with anterior disc bulging and anterior osteophytic formation, alone or in combination. Patients either presented with an initial acute medullary syndrome or with a long-standing history of spinal claudication with acute secondary pejoration.


CONCLUSIONS
Spinal ischemia can be the result of intersegmental and radiculomedullary flow impairment caused by an anterior disco-osteo-arterial conflict.
Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA.
Natalie
N
Ullman
Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA.
Lydia
L
Gregg
Department of Neurology, Transverse Myelitis Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Daniel
D
Becker
Department of Neurology, Transverse Myelitis Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Carlos
C
Pardo
Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA. phg@jhmi.edu.
Philippe
http://orcid.org/0000-0003-0768-3273
P
Gailloud
D000328:Adult; D020759:Anterior Spinal Artery Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001783:Blood Flow Velocity; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020760:Spinal Cord Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*
Spinal angiography; Spinal cord stroke; Spinal vascular anatomy; Spinal vascular pathology