[Traumatic ascending ischemic injury of the spinal cord]

We report five cases that the paraplegic level showed ascending from the segment of spinal injury upward to the higher level. In T10-11 fracture-dislocation, the paraplegic level ascended gradually to C2-3 in case 1 within 10 days and death due to breathing paralysis. In case 2, the paraplegic level ascended to cervical cord with loss of strength in both arms within 14 days. The remaining 3 cases were Ti2(in 2 cases) and L3(1 case) fracture. Their paraplegic level ascended to T8(2 cases) and T9(1 case). There were lower motor neuron paralysis in all cases. Observation on spinal cord specimen of case 1 showed thrombosis of dorsal vessels at T9-10 segment and multiple thrombosis were found in anterior spinal vessels, central spinal vessels and intramedullar small vessels upward to C3 and downward to S1 segments. The whole cord underwent ischemic necrosis.