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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Spinal+Cord+Med
2016 ; 39
(2
): 146-54
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gab.com Text
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Fibrocartilaginous embolism: a comprehensive review of an under-studied cause of
spinal cord infarction and proposed diagnostic criteria
#MMPMID26833287
AbdelRazek MA
; Mowla A
; Farooq S
; Silvestri N
; Sawyer R
; Wolfe G
J Spinal Cord Med
2016[]; 39
(2
): 146-54
PMID26833287
show ga
BACKGROUND: Most spinal cord infarctions are due to aortic pathologies and aortic
surgeries. Fibrocartilaginous Embolism (FCE) has been reported to represent 5.5%
of spinal cord infarctions. Some believe that FCE is more common than presumed
and is rather under-diagnosed due to vagueness surrounding its clinical
presentation. METHOD: A literature search was conducted for case reports of FCE
published before August 2014. PubMed, the Cochrane Central Register and Google
Scholar were searched for different combinations of the key words
"fibrocartilaginous, "nucleus pulposus", "embolism", "spinal cord",
"inter-vertebral disc", "infarction", "stroke", "paraplegia", "quadriplegia",
"myelopathy". RESULT: Fifty-five case articles were reviewed, ten of which were
translated from foreign languages. A total of 67 cases of FCE were found, 41
tissue-confirmed and 26 clinically suspected. A comprehensive summary of the
clinical anatomy, patho-physiologic mechanisms, epidemiology, diagnosis and
treatment of FCE is described, along with the conflicting opinions on its
incidence and relevance after reviewing all of the related literature. The 41
tissue proven cases are summarized and a schematic approach to the clinical
diagnosis of FCE, deducted from their clinical findings, is presented.
CONCLUSION: FCE of the spinal cord, often mis-diagnosed as transverse myelitis,
may be more common than presumed. Future research into FCE, including the
development of a chondrolytic therapy that can be given empirically upon its
clinical suspicion to acutely reverse its symptoms, may be of value.