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Occlusion of vertebral artery and anterior spinal artery in cervical facet dislocation: a prospective study using computed tomography angiography

Spinal Cord Series and Cases volume 10, Article number: 50 (2024) Cite this article

Subjects

Abstract

Study design

A prospective study.

Objective

To investigate the incidence of vertebral artery (VA) occlusion and whether anterior spinal artery (ASA) is occluded in cervical facet dislocation.

Setting

University hospital, China.

Methods

During a 2-year period, 21 conventional patients with cervical facet dislocation were prospectively enrolled. All patients received computed tomography angiography (CTA) to assess the patency of the VA, anterior radiculomedullary arteries (ARAs), and ASA at the time of injury. Clinical data were documented, including demographics, symptomatic vertebrobasilar ischemia, American Spinal Injury Association Impairment Scale (ASIA) grades, and ASA and VA radiological characteristics.

Results

VA unilateral occlusion occurred in 5 of 21 patients (24%), including 2 with unilateral facet dislocation and 3 with bilateral facet dislocation. No ASA occlusion was found in all 21 patients, including 5 with VA unilateral occlusion. No patients had symptomatic vertebrobasilar ischemia.

Conclusions

VA occlusion occurs in approximately one-fourth of cervical facet dislocations, with infrequent symptomatic vertebrobasilar ischemia. ASA is not occluded following cervical facet dislocation, even with unilateral VA occlusion.

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Fig. 1: Identification of the ASA, ARA and VA.
Fig. 2: Illustrative case of ASA visualization without VA occlusion (16 years old case).
Fig. 3: Illustrative case of ASA visualization with VA unilateral occlusion (case 3).

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The author thanks Mei-Mei Yan, Jing-Jie Li, San-Rong Qiao and Li-Rong Yu for their contributions in data collection and validation. Thanks are also owed to Nan-Jun Mei, Ting-Ping Qian, and Hong-Wei Yan for their generous assistance.

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Authors and Affiliations

  1. Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China

    Zhengfeng Zhang

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  1. Zhengfeng Zhang
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ZZ: research design, data collection, statistical analysis, and manuscript writing.

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Correspondence to Zhengfeng Zhang.

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The author declares no competing interests.

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The research protocol was approved by the Medical Ethics Committee of Xinqiao Hospital of Army Medical University. The informed consents were obtained from all participants.

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Zhang, Z. Occlusion of vertebral artery and anterior spinal artery in cervical facet dislocation: a prospective study using computed tomography angiography. Spinal Cord Ser Cases 10, 50 (2024). https://doi.org/10.1038/s41394-024-00664-z

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