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Anterior disco-osteo-arterial conflict as a cause of intersegmental arterial flow impairment and spinal cord ischemia

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Abstract

Introduction

This article describes anterior disco-osteo-arterial conflict as an insofar unsuspected mechanism of arterial flow impairment potentially leading to spinal cord ischemia and infarction.

Methods

The anterior disco-osteo-arterial conflict described in this report is illustrated with angiographic observations of patients presenting with spinal cord ischemia documented by MRI, and radiculomedullary flow impairment diagnosed by spinal digital subtraction angiography and spinal CTA.

Results

Proximal intersegmental artery flow impairment was found in association with anterior disc bulging and anterior osteophytic formation, alone or in combination. Patients either presented with an initial acute medullary syndrome or with a long-standing history of spinal claudication with acute secondary pejoration.

Conclusion

Spinal ischemia can be the result of intersegmental and radiculomedullary flow impairment caused by an anterior disco-osteo-arterial conflict.

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Authors and Affiliations

  1. Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital/Bloomberg 7218, 1800 E Orleans Street, Baltimore, MD, 21287, USA

    Natalie Ullman, Lydia Gregg & Philippe Gailloud

  2. Department of Neurology, Transverse Myelitis Center, The Johns Hopkins Hospital, Baltimore, MD, USA

    Daniel Becker & Carlos Pardo

Authors
  1. Natalie Ullman
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  2. Lydia Gregg
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  3. Daniel Becker
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  4. Carlos Pardo
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  5. Philippe Gailloud
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Corresponding author

Correspondence to Philippe Gailloud.

Ethics declarations

We declare that all human and animal studies have been approved by the Johns Hopkins Institutional Review Board Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

PG receives research grants paid to the institution from Siemens Medical and Toshiba Medical and consults for Codman Neurovascular.

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Ullman, N., Gregg, L., Becker, D. et al. Anterior disco-osteo-arterial conflict as a cause of intersegmental arterial flow impairment and spinal cord ischemia. Neuroradiology 58, 1109–1115 (2016). https://doi.org/10.1007/s00234-016-1739-1

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  • DOI: https://doi.org/10.1007/s00234-016-1739-1

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