A case report of paraplegia following an operation for thoracic aortic aneurysm--with special reference to pathological findings of the spinal cord

A 60-year-old man suffered from paraplegia after the operation for thoracic aortic aneurysm and died 10 months after the operation. Detailed examination on the distribution of spinal cord lesions and of the locations of anterior radicular arteries revealed that the spinal cord ischemia occurred at the mid-thoracic segments between T-6 and T-10; the artery of Adamkiewicz entered at T-12; another radicular artery entered at T-4. We concluded that the spinal cord ischemia was caused by the interruption of the radicular artery at T-4 and that the segments nourished by the blood flow of the artery of Adamkiewicz were intact. We suggest that in some patients important radicular arteries other than the artery of Adamkiewicz are essential to preserve blood flow to the upper or middle thoracic spinal segments.