Myelopathy thoracic spinal cord injury by fibrocartilaginous embolism

Abstract

Fibrocartilaginous embolism myelopathy is a rare clinical entity associated to a spinal cord trauma. It is characterized by a sudden intense pain back followed by rapidly progressive paraplegia, besides the presence of a sensitive level and sphincter dysfunction. Lumbar puncture is usually normal and MRI images show T2 hyperintensity in the spinal cord, besides the presence of Schmorl’s nodes. Case report: A 51-year-old man who after a Valsalva maneuver, presented thoracic spine pain and progressive paraplegia. Initially managed as Guillain-Barré syndrome and later as a radiculopathy, he presented a T4 sensory level in addition to bladder dysfunction. It was done a thoracic spine MRI that showed hyperintense images in spinal cord and Schmorl nodes. Physical therapy was initiated with unfavorable clinical progress. Conclusion: fibrocartilaginous embolism is an acute ischemic myelopathy that should be considered as a differential diagnosis in spinal injuries whose cause has not been determined.