Fibrocartilaginous emboli to the spinal cord: a case report

Fibrocartilaginous emboli to spinal cord vessels are a rare and fatal cause of spinal cord injury. We reviewed the medical literature and discovered only 24 cases reported, all in the last 28 years. For all previously reported patients, onset of initial symptoms to maximal neurologic deficit was from a few minutes to as much as two days. All 24 of these patients died an average of 9.6 weeks post-onset (range = three hours to 11 months) due to complications related to their spinal cord injury; in all cases, the pathologic diagnosis was made postmortem. We report a 20-year-old man with high-level quadriplegia and respiratory paralysis due to fibrocartilaginous emboli to spinal cord vessels, which occurred after a minor automobile accident. He was the longest-surviving patient reported with this diagnosis. He died six years and seven months after onset, having been on 24-hour ventilatory support. The pathologic diagnosis was not suspected before his death; it was made during postmortem examination.