Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury.

BACKGROUND

In addition to spinal fracture and/or dislocation, acute traumatic spinal cord injury (SCI) includes neural tissue and vascular damage at the site of contusion. Vascular damage results in spinal cord ischemia, which is a key factor that contributes to secondary pathogenesis. There is a need to identify spinal cord ischemia secondary to anterior spinal artery (ASA) rupture in acute cervical SCI.

METHODS

After admission, 20 patients with cervical SCI, including 10 cases of central cord syndrome (CCS), four cases of brown-sequard syndrome (BSS) and six cases of tetraplegia (ASIA A), had computed tomographic angiography (CTA) of ASA performed on them. ASA rupture or occlusion was observed.

RESULTS

The ASA was visualized in all 20 patients. No ASA rupture was found in CCS and BSS patients, even for sever blunt cervical fracture and dislocation tetraplegia patients, except one stab-wound patient.

CONCLUSION

CTA provides the most detailed, highest resolution imaging of ASA in acute cervical SCI. ASA rupture is not commonly seen in acute blunt cervical SCI.