Spinal Cord Infarction

What is Spinal Cord Infarction?

Also known as ischemic myelopathy, spinal cord infarction occurs when blood supply to the spinal cord is blocked. This happens when the artery carrying blood becomes obstructed. Oxygen is transported around the body in the haemoglobin of red blood cells. When blood supply is restricted, this means that oxygen supply is also inhibited and as a result, the tissue starts to die. This is known as infarction.

What causes spinal cord infarction?

Possible causes of spinal cord infarction include:

• Atherosclerosis: this is also known as hardening of the arteries and it occurs when fatty deposits collect in the walls of the arteries, causing them to narrow and subsequently reducing blood flow
• Aortic dissection: this occurs when the inner wall of the aorta tears. This is most commonly a result of high blood pressure
• Vasculitis (also known as inflammation of the blood vessels)
• Blood clot (thrombosis): a blood clot may affect the spinal cord when the clot breaks away from the heart muscle wall and travels to the spinal cord via the bloodstream.
• Complications of abdominal surgery

What are the signs and symptoms?

The first symptom people experience is severe back pain. This is followed by pain that radiates to other parts of the back, neck and shoulders. Additional symptoms include:

• muscle weakness
• loss of sensation
• numbness and paralysis in the legs (when the blockage affects the front of the spinal cord)

If the muscles become weak and paralysed, this can also affect breathing and increase the risk of bed sores and changes in bowel habits.

How is spinal cord infarction diagnosed?

A diagnosis is usually made based on symptoms and the findings of an MRI (magnetic resonance imaging) scan. In some cases, a spinal tap may be used to rule out other potential conditions, such as transverse myelitis.

How is spinal cord infarction treated?

The treatment pathway is usually dictated by the cause and this is treated as a priority. Treatment is then focused on reducing the risk of complications such as paralysis and making the patient feel more comfortable.

Physiotherapy can be helpful in restoring and building muscle strength and increasing the range of movement and occupational therapy may be required to support patients at home.

In cases where the patient has numbness of paralysis, therapies may be used to prevent pressure sores. If the function of the bowel or bladder is affected, a catheter will be fitted.

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