Anterior spinal artery syndrome caused by thoracic disc herniation.

TitleAnterior spinal artery syndrome caused by thoracic disc herniation.
Publication TypeJournal Article
Year of Publication2020
AuthorsSantillan A, Goldberg JL, Carnevale JA, Kirnaz S, Härtl R, Knopman J
JournalJ Clin Neurosci
Date Published2020 Jul
KeywordsAngiography, Anterior Spinal Artery Syndrome, Back Pain, Diskectomy, Female, Humans, Intervertebral Disc Displacement, Magnetic Resonance Imaging, Middle Aged, Paraparesis, Spinal Fusion, Thoracic Vertebrae

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.

Alternate JournalJ Clin Neurosci
PubMed ID32409217