Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center

Global Spine Journal, 2020 · DOI: 10.1177/2192568219877863 · Published: June 1, 2020

Simple Explanation

Spinal cord injuries (SCI) lead to high health care expenses and diminished quality of life. Spinal cord ischemia and infarcts are rare causes of cord injury that deserve further analysis. Spinal cord ischemia and infarction occur when blood flow to the spinal cord is restricted, disrupting oxygen and glucose delivery, and subsequent metabolic failure of the cord tissue. Risk factors for spinal cord infarcts are undoubtedly changing, as the prevalence of abdominal aortic aneurysm (AAA) in patients older than 65 years and in particular those with a cigarette smoking history have increased.

Study Duration

January 2003 to January 2014

Participants

685 unique SCI patients

Evidence Level

Level 3: Retrospective study

Key Findings

1
Spinal cord infarcts accounted for 4.4% of SCI cases.
2
The most common causes of spinal cord infarct were abdominal aortic aneurysm (AAA) repairs, arteriovenous fistulas, and unknown causes, each accounting for 20% of cases.
3
Surgical complications leading to cord infarcts were associated with a higher severity of injury.

Research Summary

This study evaluated the demographics, prevalence, etiology, severity, and outcomes of spinal cord injuries (SCIs) resulting from ischemic infarction. The study found that spinal cord infarcts accounted for 4.4% of SCI cases, with the most common causes being AAA repairs, arteriovenous fistulas, and unknown causes. Outcomes were worse than previously reported in the literature, with a higher proportion of patients remaining wheelchair bound.

Practical Implications

Holistic Approach to Infarcts

Providers and researchers should consider spinal cord infarcts with a more holistic approach, recognizing that these injuries occur not only with aortic pathologies but with many others.

Awareness of Poor Prognosis

Providers and caretakers should be aware of the relatively poor prognosis of SCIs as a result of infarction, particularly in those with more severe initial presentation.

Referral to SCI Centers

These cases should be managed at or referred to SCI rehabilitation centers.

Study Limitations

1
Single center study
2
Varied follow-up length and loss of follow-up
3
Limited sample size and lack of a control group

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury