Fibrocartilaginous emboli occur when material from the nucleus pulposus enters the circulation.
Presentation:
(1) sudden onset of paraplegia or quadriplegia
(2) anterior spinal artery syndrome
Pathogenesis: embolization of nucleus pulposus
Precipitating events:
(1) spinal surgery
(2) fall or other trauma
(3) Valsalva maneuver
Emboli may lodge in:
(1) spinal cord vessel, affecting the spinal cord and/or vertebrae
(2) lung
(3) brain
(4) ribs
With spinal disease MRI shows:
(1) ischemic myelopathy with T2 weighted hyperintensity initially
(2) variable degenerative disc pathology (herniation, Schmorl's nodules, etc)
Differential diagnosis:
(1) transverse myelitis
(2) nonembolic ischemia
