[Anterior spinal artery syndrome after thoraco-abdominal esophagus resection. A rare complication]

We report a case of postoperative paraplegia resembling an anterior spinal artery syndrome after curative esophagectomy in a patient with carcinoma of esophagus and clinical stage III (UICC). Neurologic deficit was characterized by loss of sensibility at the level of T12/L1 together with paraparesis of both lower extremities. Furthermore, dissociated sensorimotor depletion at C6/C7 (right-sided) and at T5 (left-sided) was noted. This severe complication was most probably caused by peeling of an arteriosclerotic plaque of the thoracic aorta due to preexisting advanced arteriosclerosis, leading to a partial occlusion of the great radicular artery of Adamkiewicz. Even though anterior spinal artery syndrome is a well-known problem in the operative management of thoracic aortic aneurysms, this complication has not previously been reported after esophagectomy.