Pediatric fibrocartilaginous spine embolism induced by trauma

Abstract

Fibrocartilaginous embolic infarction of the spinal cord is a rare cause of acute back pain and motor weakness. Most symptoms start after minor trauma that is often considered harmless and forgotten, however these minor injuries can result in lethal consequences. It is quite rare to diagnose fibrocartilaginous embolism in a timely manner and start treatment to prevent poor outcomes. We present the case of a previously healthy eight-year-old female with sudden onset neck pain and progressive bilateral upper extremity weakness following an injury while playing with her younger sister. Magnetic resonance imaging of the cervical spinal cord without contrast revealed a posterior disc protrusion suggestive of post-traumatic spinal cord infarction due to fibrocartilaginous embolism. In young, otherwise healthy, patients with acute motor deficits, radiographic imaging can help identify rare presentations like fibrocartilaginous embolism in order to rapidly diagnose and efficiently treat such patients.

Anterior Spinal Artery Syndrome Due to Fibrocartilaginous Embolism—Case Report and Treatment Options

“…Introduction: Acute occlusion of the anterior spinal artery and the resulting ischemia leads to the symptom complex of anterior spinal artery syndrome. Among very rare conditions, causes include arteriosclerosis 1 , dissecting aneurysm, coagulation disorders 2 , trauma 3 , hematologic diseases (sickle cell anemia, polycythemia, leukemia), infections (syphilis, tuberculosis, arachnoiditis, meningitis) dissecting aneurysm, vasculitis, or iatrogenic (aortic surgery, angiography, chiropractic manipulation) 4 . Fibrocartilaginous embolism (FCE),), a rare condition that causes spinal cord infarction and necrotic myelopathy [5][6][7] , was first proposed to be caused by an axial loading of the spine with retrograde entry of fibrocartilage into the radicular artery in 1965 8 .…”