New idea of pathogenesis of impaired circulation in traumatic cervical spinal twine harm and its affect on illness severity: case collection of 4 sufferers.
Eur Backbone J. 2016 Could;25 Suppl 1:11-Eight
Authors: Salkov M, Tsymbaliuk V, Dzyak L, Rodinsky A, Cherednichenko Y, Titov G
PURPOSE: The aim of this examine is to justify a brand new idea of the pathogenesis of secondary adjustments within the cervical spinal twine, and its correlation with the depth of improvement of neurological issues in spinal harm.
METHODS: Commonplace magnetic resonance imaging examination and angiography of the cervical and vertebral arteries of 4 sufferers have been carried out to diagnose the prevalence fee of ischemia and edema, and look at the spinal twine vasculature. Correlation of the information obtained with the neurological standing was carried out.
RESULTS: Collateral circulation is most obvious within the upper-cervical area, above the C4 vertebra. Following occlusion of the vertebral artery, the circulation above the C4 vertebra is carried out by collaterals of the ascending cervical artery. With intensive injury to the spinal twine, the depth of edema and ischemia could be thought to be the impact of harm to radicular medullary arteries, that are injured within the intervertebral foramen. Secondary adjustments of the spinal twine are most obvious by impaired circulation within the artery of cervical enlargement.
CONCLUSIONS: Collateral circulation is a big issue that limits the injury to the cervical spinal twine. Impaired circulation within the artery of cervical enlargement is important in extension of perifocal ischemia. The looks of early arteriovenous shunting within the area of a major spinal twine harm (contusion focus) by angiography is pathognomonic. The info obtained open a perspective for the endovascular therapy of spinal twine harm.
PMID: 25976016 [PubMed – indexed for MEDLINE]