Occlusion of Vertebral Artery and Anterior Spinal Artery in Cervical Facet Dislocation: a Prospective Study Using Computed Tomography Angiography

Overview

Journal Spinal Cord Ser Cases

Specialty Neurology

Date 2024 Jul 23

PMID 39043672

Authors

Zhengfeng Zhang

Affiliations

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Abstract

Study Design: A prospective study.

Objective: To investigate the incidence of vertebral artery (VA) occlusion and whether anterior spinal artery (ASA) is occluded in cervical facet dislocation.

Setting: University hospital, China.

Methods: During a 2-year period, 21 conventional patients with cervical facet dislocation were prospectively enrolled. All patients received computed tomography angiography (CTA) to assess the patency of the VA, anterior radiculomedullary arteries (ARAs), and ASA at the time of injury. Clinical data were documented, including demographics, symptomatic vertebrobasilar ischemia, American Spinal Injury Association Impairment Scale (ASIA) grades, and ASA and VA radiological characteristics.

Results: VA unilateral occlusion occurred in 5 of 21 patients (24%), including 2 with unilateral facet dislocation and 3 with bilateral facet dislocation. No ASA occlusion was found in all 21 patients, including 5 with VA unilateral occlusion. No patients had symptomatic vertebrobasilar ischemia.

Conclusions: VA occlusion occurs in approximately one-fourth of cervical facet dislocations, with infrequent symptomatic vertebrobasilar ischemia. ASA is not occluded following cervical facet dislocation, even with unilateral VA occlusion.

References

Taneichi H, Suda K, Kajino T, Kaneda K . Traumatically induced vertebral artery occlusion associated with cervical spine injuries: prospective study using magnetic resonance angiography. Spine (Phila Pa 1976). 2005; 30(17):1955-62. DOI: 10.1097/01.brs.0000176186.64276.d4. View

Louw L, Steyl J, Loggenberg E . Imaging of Unilateral Meningo-ophthalmic Artery Anomaly in a Patient with Bilateral Nasopharyngeal Angiofibroma. J Clin Imaging Sci. 2015; 4:65. PMC: 4278099. DOI: 10.4103/2156-7514.145889. View

Zhang Z, Wang H, Mu Z . Vertebral Artery Occlusion and Recanalization After Cervical Facet Dislocation. World Neurosurg. 2016; 95:190-196. DOI: 10.1016/j.wneu.2016.08.002. View

ISELI E, Cavigelli A, Dietz V, Curt A . Prognosis and recovery in ischaemic and traumatic spinal cord injury: clinical and electrophysiological evaluation. J Neurol Neurosurg Psychiatry. 1999; 67(5):567-71. PMC: 1736605. DOI: 10.1136/jnnp.67.5.567. View

Even J, McCullough K, Braly B, Hohl J, Song Y, Lee J . Clinical indications for arterial imaging in cervical trauma. Spine (Phila Pa 1976). 2011; 37(4):286-91. DOI: 10.1097/BRS.0b013e31821b37b9. View

Waters R . Functional prognosis of spinal cord injuries. J Spinal Cord Med. 1996; 19(2):89-92. View

Yagi M, Ninomiya K, Kihara M, Horiuchi Y . Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on Magnetic Resonance imaging. J Neurosurg Spine. 2010; 12(1):59-65. DOI: 10.3171/2009.5.SPINE08940. View

Giacobetti F, Vaccaro A, Deeley D, Albert T, FARMER J, COTLER J . Vertebral artery occlusion associated with cervical spine trauma. A prospective analysis. Spine (Phila Pa 1976). 1997; 22(2):188-92. DOI: 10.1097/00007632-199701150-00011. View

Willis B, Greiner F, Orrison W, Benzel E . The incidence of vertebral artery injury after midcervical spine fracture or subluxation. Neurosurgery. 1994; 34(3):435-41; discussion 441-2. DOI: 10.1227/00006123-199403000-00008. View

10.

Vaccaro A, Klein G, Flanders A, Albert T, Balderston R, COTLER J . Long-term evaluation of vertebral artery injuries following cervical spine trauma using magnetic resonance angiography. Spine (Phila Pa 1976). 1998; 23(7):789-94; discussion 795. DOI: 10.1097/00007632-199804010-00009. View

11.

Turnbull I, Brieg A, HASSLER O . Blood supply of cervical spinal cord in man. A microangiographic cadaver study. J Neurosurg. 1966; 24(6):951-65. DOI: 10.3171/jns.1966.24.6.0951. View

12.

Zhang Z, Wang H, Zhou Y, Wang J . Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury. Spinal Cord. 2013; 51(6):442-7. DOI: 10.1038/sc.2012.179. View

13.

Zhang Z, Wang H . Is the "snake-eye" MRI sign correlated to anterior spinal artery occlusion on CT angiography in cervical spondylotic myelopathy and amyotrophy?. Eur Spine J. 2014; 23(7):1541-7. DOI: 10.1007/s00586-014-3348-1. View

14.

Xiong M, Zhang Z . Is the anterior spinal artery occluded in severe cervical compressive myelopathy?. J Spinal Cord Med. 2019; 44(5):765-769. PMC: 8477960. DOI: 10.1080/10790268.2019.1693193. View