Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: An unusual catastrophic complication

Background. Spinal cord injury is a possible complication associated with r emoval of thoracic dumbbell neuroblastomas. Our experience with two childre n whose postsurgical course was complicated by midthoracic spinal cord isch emia is reported there. Permanent paraplegia resulted in both. Procedure an d Results. Preoperative awareness of the origin and distribution of the Ada mkiewicz artery (arteria radiculomedullaris magna, ARMM) and of the possibl e collateral pathways for spinal cord blood supply may be helpful in the pl anning of operations that. involve dissection in the midthoracic posterior mediastinum. Otherwise, a flaccid paraplegia may result. Conclusions. The s yndrome is presumed to be triggered by a spasm, an embolism, or a iatrogeni c interruption of the ARMM. Med. Pediatr. Oncol. 32:349-352, 1999. (C) 1999 Wiley-Liss, inc.