Causes include severe atherosclerosis, inflammation of blood vessels, blood clots, and sometimes procedures that involve the abdominal aorta.
Sudden back pain with pain radiating from the affected area is followed by muscle weakness and inability to feel heat, cold, or pain in the affected areas and sometimes paralysis.
Magnetic resonance imaging or myelography with computed tomography is usually done.
Treatment focuses on correcting the cause if possible or relieving symptoms.
Spinal cord dysfunction and paralysis are usually permanent.
(See also Overview of Spinal Cord Disorders Overview of Spinal Cord Disorders Spinal cord disorders can cause permanent severe problems, such as paralysis or impaired bladder and bowel control ( urinary incontinence and fecal incontinence). Sometimes these problems can... read more .)
Like all tissues in the body, the spinal cord requires a constant supply of oxygenated blood. Only a few arteries, which are branches of the aorta, supply blood to the front part of the spinal cord. But this blood accounts for three fourths of the blood the spinal cord receives. Thus, blockage of any one of these arteries can be disastrous. Such a blockage occasionally results from the following:
Severe atherosclerosis Atherosclerosis Atherosclerosis is a condition in which patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or... read more of the aorta (deposits of fatty material in the aorta's wall)
Procedures that involve the abdominal aorta, such as surgery to repair a bulge (aneurysm) there
A blood clot that breaks off from the wall of the heart and travels through the bloodstream (becoming an embolus)—an uncommon cause
Inflammation of blood vessels ( vasculitis Overview of Vasculitis Vasculitic disorders are caused by inflammation of the blood vessels (vasculitis). Vasculitis can be triggered by certain infections or drugs or can occur for unknown reasons. People may have... read more ), such as polyarteritis nodosa Polyarteritis Nodosa (PAN) Polyarteritis nodosa is a form of vasculitis involving inflammation of medium-sized arteries. Any organ can be affected but usually not the lungs. Polyarteritis nodosa can be rapidly fatal or... read more —a rare cause
The first symptoms of a blocked spinal cord artery are usually
Sudden back pain that radiates from the center of the back around the rib cage and chest
The pain is followed by muscle weakness, and people cannot feel heat, cold, or pain in areas controlled by the part of the spinal cord below the level of the blockage. People immediately notice symptoms, which may lessen slightly over time.
If the blood supply to the front of the spinal cord is greatly reduced, the legs are numb and paralyzed. But sensations transmitted through the back of the cord—including touch, the ability to feel vibration, and the ability to sense where the limbs are without looking at them (position sense)— remain intact because the back of the cord receives blood from other sources. Problems may partly resolve after the first few days.
Weakness and paralysis can lead to the development of pressure sores Pressure Sores Pressure sores are areas of skin damage resulting from a lack of blood flow due to prolonged pressure. Pressure sores often result from pressure combined with pulling on the skin, friction,... read more and breathing difficulties. Bladder and bowel function may be impaired, as may sexual function.
Magnetic resonance imaging or myelography with computed tomography (CT)
Sometimes a spinal tap
Blockage of the spinal cord’s blood supply is usually suspected based on symptoms.
Magnetic resonance imaging (MRI) usually enables doctors to diagnose such a blockage. If MRI is unavailable, myelography Myelography Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more with CT, is done. These tests can help doctors rule out other disorders that cause similar symptoms.
A spinal tap Spinal Tap (lumbar puncture) may also be done to rule out other disorders that cause similar symptoms, such as transverse myelitis Acute Transverse Myelitis Acute transverse myelitis is inflammation that affects the spinal cord across its entire width (transversely) and thus blocks transmission of nerve impulses traveling up or down the spinal cord... read more .
Angiography Angiography In angiography, x-rays are used to produce detailed images of blood vessels. It is sometimes called conventional angiography to distinguish it from computed tomography (CT) angiography and magnetic... read more can confirm that an artery to the front of the spinal cord is blocked, but it is usually unnecessary.
Treatment of the cause when possible
Relief of symptoms
When possible, the cause (such as aortic dissection or polyarteritis nodosa) is treated, but otherwise, treatment focuses on relieving symptoms and managing complications, especially when paralysis and spinal cord dysfunction do not resolve in the first few days and become permanent.
Because breathing can be affected, therapy to help prevent pneumonia Chest Physical Therapy Chest physical therapy uses mechanical techniques, such as chest percussion, postural drainage, and vibration, to help clear secretions from the lungs. Respiratory therapists use several different... read more from developing may be necessary. Such therapy includes deep breathing exercises, postural drainage (positioning the person so that gravity helps drain secretions from the lungs), and suctioning (inserting a small plastic tube through the nose and into the windpipe to gently suck out secretions).
Physical therapy Physical Therapy (PT) Physical therapy, a component of rehabilitation, involves exercising and manipulating the body with an emphasis on the back, upper arms, and legs. It can improve joint and muscle function, helping... read more and occupational therapy Occupational Therapy (OT) Occupational therapy, a component of rehabilitation, is intended to enhance a person's ability to do basic self-care activities, useful work, and leisure activities. These activities include... read more can help preserve muscle function.
Because bladder function is usually impaired, a catheter is needed to drain urine. This treatment prevents the bladder from enlarging and being damaged.