Quiz Form

Question Date: 31/08/2023

Question: A 25-year-old woman squats and attempts to help her roommate lift a heavy chest to move it from one room to another. She strains significantly, but is unable to lift and move her end. Within minutes she develops weakness of both legs, which worsens during the hour it takes her to present to the emergency department. She has also developed loss of temperature and pain sensation in her legs below T9 and is unable to void her bladder. A spine MRI shows no evidence of disk herniation or vertebral fracture<br><br>What is the most likely cause of her spinal cord injury?

Options:

• Aortic dissection
• Epidural hematoma
• Fibrocartilaginous embolism
• Spinal cavernous angioma hemorrhage

Correct Answer: Fibrocartilaginous embolism

Explaination: Spinal cord infarction due to fibrocartilaginous embolism may account for up to 5% of cases of spinal cord infarction. It is thought that acute herniation of nucleus pulposus fragments is followed by retrograde embolization into a radicular artery with resultant infarction. Increased pressure within a disk from axial loading of the vertebral column as occurs in lifting is thought to be one precipitating event

Reference: Page 68, Rabinstein AA. Vascular myelopathies. Continuum (Minneap Minn). 2015 Feb21(1 Spinal Cord Disorders)67-83. doi 10.121201.CON.0000461085.79241.e0. PMID 25651218.