Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Spinal Cord Ser Cases. 2021 Apr 13;7(1):28. doi: 10.1038/s41394-021-00395-5.
There have been 30 clinically suspected cases and 41 histopathologically confirmed cases of fibrocartilaginous embolism (FCE) reported in the literature. FCE often has a poor prognosis and is estimated to represent 5.5% of spinal cord infarctions, but may be more common than initially presumed given underdiagnosis due to its vague clinical presentation.
We report two cases, a 15-year-old male and a 15-year-old female, whose clinical history, examination, and imaging findings were consistent with spinal cord infarction secondary to FCE.
These cases were unique given our patients' neurologic improvement; however, the commonly held assumption of poor prognosis may in part be fueled by the preferential case ascertainment via biopsy on autopsy. These cases highlight the importance of recognizing rare causes of spinal cord pathology and considering FCE in the differential diagnosis of acute myelopathy.
文献中报道了 30 例临床疑似纤维软骨栓子（FCE）病例和 41 例组织病理学确诊病例。FCE 预后通常较差，据估计占脊髓梗死的 5.5%，但由于其临床表现模糊，漏诊率较高，可能比最初推测的更为常见。
我们报告了两例病例，一例为 15 岁男性，一例为 15 岁女性，其临床病史、检查和影像学结果均符合继发于 FCE 的脊髓梗死。
这些病例较为特殊，因为我们的患者神经功能有所改善；然而，预后不良的普遍假设部分可能归因于尸检时通过活检进行的选择性病例确定。这些病例强调了认识脊髓病理罕见病因的重要性，并在急性脊髓病的鉴别诊断中考虑 FCE。
