Natalie Ullman1, Lydia Gregg1, Daniel Becker2, Carlos Pardo2, Philippe Gailloud3. 1. Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA. 2. Department of Neurology, Transverse Myelitis Center, The Johns Hopkins Hospital, Baltimore, MD, USA. 3. Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA. phg@jhmi.edu.
Abstract
INTRODUCTION: 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. CONCLUSION: Spinal ischemia can be the result of intersegmental and radiculomedullary flow impairment caused by an anterior disco-osteo-arterial conflict.
INTRODUCTION: 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. CONCLUSION: Spinal ischemia can be the result of intersegmental and radiculomedullary flow impairment caused by an anterior disco-osteo-arterial conflict.