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Two spinal cord lesions in a patient with ankylosing spondylitis and cervical spine injury

Spinal Cord Injury (Drs. Foo and Rossier), Neurology (Dr. Fool, and Spinal Cord Reseach Laboratory Services (Dr. Bignami), West Roxbury Veterans Administration Medical Center, and the Departments of Neurology (Dr. Foo). Neuropathology (Dr. Bignami), and Orthopaedic Surgery (Dr. Rossier), Harvard Medical School, Boston, MA.

A patient with ankylosing spondylitis sustained C3-C4 vertebral subluxation and C4-C5 myelopathy after a hyperextension trauma. Autopsy showed that several segments below the main cervical cord lesion at the fractured site, there was a second spinal cord lesion at the T1 vertebral level with no corresponding local bony or ligamentous damage. The thoracic cord lesion was probably secondary to traction of the upper thoracic cord, where the blood supply is poor, in a narrow and rigid spinal canal at the moment of extreme hyperextension.

Address correspondence and reprint requests to Dr. Foo, West Roxbury Veterans Administration Medical Center, 1400 VFW Parkway, Boston, MA 02132.

Accepted for publication June 15, 1982.

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