Large radicular artery ischemia syndrome supplying blood to the thoracolumbar spinal cord
Introduction
Introduction to large root arterial ischemic syndrome supplying blood to the thoracolumbar spinal cord The root arteries of this group are mostly from the intercostal artery, or from the upper lumbar artery and/or the external iliac artery. After entering the spinal canal along the intercostal or lumbar spinal nerve, they participate in the anterior central artery of the spinal cord in the middle and lower part of the spinal cord. The sixth thoracic cord is above the thoracic segment, and the lower part is 4; the lumbar segment is the thoracic 12 to 5, which mainly supplies 2/3 of the blood in front of the spinal cord. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications:
Cause
Causes of large root artery ischemic syndrome supplying blood to the thoracolumbar spinal cord
(1) Causes of the disease
Due to trauma, surgery can cause the disease by accidentally injuring the large root artery or by compressing the large root artery.
(two) pathogenesis
1. Vascular disease is less common in patients with vascular sclerosis caused by hardening of the arteries, such as atherosclerosis, and it is mostly gradual.
2. Injury refers to intercostal arteries, lumbar arteries or ankle blood vessels that cause large root arteries due to trauma or surgical injury, especially in the latter, so that both lower extremity paralysis occurs in the early postoperative period, except for orthopedic surgery, abdominal surgery, women Surgery such as obstetrics and urology can also occur.
3. Tumor compression can occasionally encounter large root arteries or intercostal arteries, and nearby tumors such as the lumbar artery can block the vascular branch, including intraspinal and retroperitoneal tumors.
Prevention
Prevention of large root ischemia syndrome in blood supply to the thoracolumbar spinal cord
The key to the disease is prevention, especially when the site is being treated (especially for tumor resection). Do not ligature the blood vessels during surgery.
Complication
Complications of large root ischemia syndrome in blood supply to the thoracolumbar spinal cord Complications
Can be combined with lower limb paralysis.
Symptom
Symptoms of large root arterial ischemia syndrome supplying blood to the thoracolumbar spinal cord Common symptoms Gastrointestinal dysfunction Sensory disturbance Hypersensitivity Motor dysfunction
1. Most of the lower extremities are typical peripheral paralysis, and they occur faster, often sudden.
2. The level of the thoracic segment of the sensory disorder is higher. Most of the numbness begins to appear numbness, pain, hyperesthesia and even painful temperature and sensation disappear. Because the posterior spinal artery still has blood supply, it generally retains some sensory functions. When the segmental root artery is involved, the plane is lower, generally below the groin.
3. Visceral dysfunction Due to spinal cord conduction function and sympathetic nerve fibers, patients may have incontinence and gastrointestinal dysfunction.
The extent of the above symptoms depends mainly on the degree of vascular obstruction and the rate of development.
Examine
Examination of large root arterial ischemic syndrome supplying blood to the thoracolumbar spinal cord
1. Angiography is mainly determined by digital subtraction angiography.
2. Magnetic resonance has softened the spinal cord, and the transgender can be judged from the extent of its lesion.
Diagnosis
Diagnosis and diagnosis of large root arterial ischemia syndrome supplying blood to the thoracolumbar spinal cord
1. The cause of the disease immediately after the operation or immediately after the trauma of the thoracolumbar, should consider the possibility of obstruction of the large root artery supplying blood to the thoracolumbar spinal cord, and early surgical exploration.
2. Characteristics of clinical symptoms Among the above three symptoms, motor dysfunction is the earliest and more serious.
3. Angiography is mainly determined by digital subtraction angiography.
4. Magnetic resonance has softened the spinal cord, and the transgender can be judged from the extent of its lesion.
