Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
J Endovasc Ther. 2010 Feb;17(1):131-6. doi: 10.1583/09-2837MR-R.1.
To describe a rare case of spinal cord injury without radiographic abnormalities (SCIWORA) associated with a traumatic aortic transection.
A 48-year-old man was transferred for endovascular treatment of a traumatic aortic transection. Primary traumatic paraplegia had been documented at the scene of the accident. No osseous or ligamentous injuries were found in the conventional radiographic images. The transection was treated successfully with an endovascular stent-graft, but the patient remained paraplegic. On the magnetic resonance images 8 days later, discrete trauma of the intraspinal ligament at T1/T2 was seen, without signs of injury to the myelum. The patient made a slow but incomplete recovery after that.
SCIWORA very rarely affects the thoracic spinal cord in adults; therefore, a vascular injury in relation to the trauma of the aorta is assumed. When spinal cord damage is noted after stent-grafting or open aortic surgery for traumatic transection, SCIWORA should be ruled out by history and neurological examination.
描述一例与创伤性主动脉夹层相关的无放射影像学异常的脊髓损伤（SCIWORA）。
一名 48 岁男性因创伤性主动脉夹层而行血管内治疗而转入。在事故现场已记录到原发性创伤性截瘫。常规放射影像学图像未发现骨或韧带损伤。夹层经血管内支架置入术成功治疗，但患者仍截瘫。8 天后的磁共振成像显示 T1/T2 椎管内韧带离散性损伤，无脊髓损伤迹象。此后，患者恢复缓慢但不完全。
成人罕见胸段脊髓 SCIWORA；因此，假设与主动脉创伤相关的血管损伤。当支架置入术或开放性主动脉手术后注意到脊髓损伤时，应通过病史和神经系统检查排除 SCIWORA。
