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European Spine Journal
Published in: European Spine Journal 1/2016

01-05-2016 | Case Report

New concept of pathogenesis of impaired circulation in traumatic cervical spinal cord injury and its impact on disease severity: case series of four patients

Authors: M. Salkov, V. Tsymbaliuk, L. Dzyak, A. Rodinsky, Y. Cherednichenko, G. Titov

Published in: European Spine Journal | Special Issue 1/2016

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Abstract

Purpose

The purpose of this study is to justify a new concept of the pathogenesis of secondary changes in the cervical spinal cord, and its correlation with the depth of development of neurological disorders in spinal injury.

Methods

Standard magnetic resonance imaging examination and angiography of the cervical and vertebral arteries of four patients were performed to diagnose the prevalence rate of ischemia and edema, and examine the spinal cord vasculature. Correlation of the data obtained with the neurological status was performed.

Results

Collateral circulation is most apparent in the upper-cervical region, above the C4 vertebra. Following occlusion of the vertebral artery, the circulation above the C4 vertebra is performed by collaterals of the ascending cervical artery. With extensive damage to the spinal cord, the intensity of edema and ischemia can be regarded as the effect of damage to radicular medullary arteries, which are injured in the intervertebral foramen. Secondary changes of the spinal cord are most apparent by impaired circulation in the artery of cervical enlargement.

Conclusions

Collateral circulation is a significant factor that limits the damage to the cervical spinal cord. Impaired circulation in the artery of cervical enlargement is significant in extension of perifocal ischemia. The appearance of early arteriovenous shunting in the region of a primary spinal cord injury (contusion focus) by angiography is pathognomonic. The data obtained open a perspective for the endovascular treatment of spinal cord injury.
Literature
1.
Anderson DK, Hall ED (1989) Pathophysiology of spinal cord trauma. Ann Emerg Med 22:987–992CrossRef
2.
Fehlings MG, Vaccaro AR, Boakye M et al (2013) Essentials of spinal cord injury: basic research to clinical practice. Thieme, New YorkCrossRef
3.
Sandler AN, Tator CH (1976) Review of the effect of spinal cord trauma on the vessels and blood flow in the spinal cord. J Neurosurg 45:638–646CrossRefPubMed
4.
Tator CH, Fehlings MG (1991) Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms. J Neurosurg 75:15–26CrossRefPubMed
5.
Tator CH (1995) Update on pathophysiology and pathology of acute spinal cord injury. Brain Pathol 5(4):407–413CrossRefPubMed
6.
Lazorthes G et al (1962) La vascularisation de la moelle epiniere (etude anatomique et physiologique). Rev Neurol 106(6):535–557
7.
Lazorthes G, Gouaze A, Zadeh JO, Santini JJ, Lazorthes Y, Burdin P (1971) Arterial vascularization of the spinal cord. J Neurosurg 35(September):253–262CrossRefPubMed
8.
Lazorthes G, Gouaze A, Djindjian R (1973) Vascularisation et circulation de la moelle epiniere, anatomie, physiologie, pathologie, angiographie. Masson & Cie, Paris
Metadata
Title
New concept of pathogenesis of impaired circulation in traumatic cervical spinal cord injury and its impact on disease severity: case series of four patients
Authors
M. Salkov
V. Tsymbaliuk
L. Dzyak
A. Rodinsky
Y. Cherednichenko
G. Titov
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4015-x

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