Anterior spinal artery syndrome

Anterior spinal artery syndrome is actually a disease with a very low incidence rate. However, once a patient suffers from this type of disease, it will cause paralysis of the whole body, which has a great impact on life and health. Neurological function can only be slowly restored through treatment. Current medical technology can only relieve symptoms of anterior spinal artery syndrome, but cannot completely cure it, and the treatment is very expensive.

Anterior spinal artery syndrome (anterior spinal arteria syndrome) is also known as Beck syndrome, Davison syndrome, anterior spinal artery occlusive syndrome, etc. The clinical characteristics of this disease are involvement of the anterior spinal artery distribution area, causing limb paralysis, pain and temperature sensation disorders, and rectal bladder sphincter disorders. Aliases: anterior spinal artery occlusion syndrome; Beck syndrome; Davison syndrome; spinal anterior artery syndrome; Anterior spinal artery occlusion syndrome. First reported by Preobranshenski in 1904. The occurrence of this disease has an increasing trend, and children also account for a certain proportion of the disease. Zhou Huaiwei et al. in China reported 15 cases in 1983.

Examination and treatment

Laboratory tests showed no specific results, and cerebrospinal fluid examination results were mostly within the normal range, with occasional increases in total protein. Do X-ray, angiography, CT and MRI examinations.

The treatment of this syndrome should be targeted at the cause. Anticoagulants, anti-infection therapies, symptomatic treatment, physical therapy to promote functional recovery, traditional Chinese medicine and acupuncture treatment can have good therapeutic effects. In general cases, after comprehensive treatment, the sphincter function returns to normal first, followed by the disappearance of sensory impairment, and motor function recovers last. The longer the disease course, the worse the recovery.

The prognosis of the disease depends on the cause, the damaged part and the extent of the lesion. Most of the time, there are some sequelae, and those with mild symptoms can walk within a few days. Prevent strenuous exercise and cervical spine trauma, prevent and treat various infectious diseases, and prevent and treat various diseases that can cause stenosis or occlusion of the anterior spinal artery.

Differential diagnosis:

(1) Spinal intermittent claudication should be differentiated from vascular intermittent claudication, the latter of which is characterized by low skin temperature and weakened or absent dorsalis pedis artery pulsation. Ultrasound Doppler examination can help with the differentiation.

(2) Acute myelitis presents with acute onset of transverse spinal cord lesions, often with a history of prior infection or vaccination. The onset is not as rapid as vascular disease, and the CSF cell count may increase. 1. The treatment principles for ischemic spinal vascular disease are similar to those for ischemic stroke. Vasodilators and drugs that promote neurological recovery can be used. Blood pressure should be corrected for patients with hypotension, and sedatives and analgesics can be given to patients with obvious pain. 2. Epidural or subdural hematoma should be removed by emergency surgery to relieve spinal cord compression. Other types of intraspinal bleeding should be treated according to the cause, using dehydrating agents, hemostatic agents, etc. Spinal vascular malformations can be treated by vascular ligation, resection or interventional embolization. 3. Paraplegic patients should receive enhanced care to prevent complications such as bedsores and urinary tract infections. After the acute phase or when the condition stabilizes, limb function training and rehabilitation treatment should be started as soon as possible.