Anterior spinal artery syndrome caused by thoracic disc herniation

May 23, 2020

Case Reports

. 2020 May 11;S0967-5868(20)30889-4.

doi: 10.1016/j.jocn.2020.05.040.

Online ahead of print.

Affiliations

¹ Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
² Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
³ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁴ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁵ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁶ Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].

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Case Reports

Alejandro Santillan et al.

J Clin Neurosci.

2020.

. 2020 May 11;S0967-5868(20)30889-4.

doi: 10.1016/j.jocn.2020.05.040.

Online ahead of print.

Affiliations

¹ Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
² Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
³ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁴ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁵ Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].
⁶ Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, United States. Electronic address: [email protected].

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Abstract

We present a case of a midline thoracic disc herniation causing acute anterior spinal artery (ASA) syndrome successfully managed surgically. A 54-year-old female with no significant past medical history presented with sudden onset severe back pain followed by rapidly evolving paraparesis with urinary and bowel incontinence. Her neurological exam was consistent with ASA syndrome. An MRI revealed T2 signal change in the thoracic spinal cord and midline disc herniation at the level of T8/T9. Spinal angiography revealed an ASA arising the right T11 segmental artery with no flow towards the T8/T9 region. The patient underwent a T8/T9 discectomy with a lateral interbody fusion that resulted in dramatic clinical improvement. A postoperative angiogram confirmed improvement of flow in the ASA. This is the first report of an angiographically confirmed symptomatic ASA syndrome caused by a thoracic disc herniation successfully managed with up-front surgery.

Keywords:

Angiography; Anterior spinal artery; Lumbar interbody fusion; Thoracic disc herniation.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.