A fibrocartilaginous embolism (FCE) occurs when fibrocartilage from a nearby intervertebral disc makes its way into the bloodstream. This fibrocartilage then lodges in a blood vessel to the spine, blocking blood flow. When the spinal cord does not have a constant blood supply, it cannot function, causing the symptoms of weakness or inability to use the limbs. Depending on where the injury occurs, an FCE can affect all four limbs, just the hind limbs, or the limbs on one side of the body. The onset is usually fast with initial pain that resolves.
Clinical signs of a fibrocartilaginous embolism range from very mild to complete paralysis. There is usually an acute onset of symptoms with a sudden change in function. Signs can include loss of movement in the limbs, dragging or scuffing of the toes, stumbling or falling, impaired coordination, and decreased sensation.
An MRI is used to definitively diagnose a fibrocartilaginous embolism and to rule out other potential sources of neurological decline. Anesthesia is required for an MRI.
The spinal cord cannot repair areas that have been damaged, but it has a great ability to reroute around areas of damage through a process called neuroplasticity. Through this process, the spinal cord is able to use healthy areas to do the function of damaged areas.
During rehab, we utilize electrotherapy, laser therapy, ultrasound therapy, and pain medications to get pain under control. We then focus on relaxing the muscles surrounding the spine and doing exercises to improve sensation and proprioception (the awareness of where the limbs are in space). A major component of our rehab after an fibrocartilaginous embolism (FCE) is aimed at improving transitions and doing gait retraining
We work on positional balance exercises and then progress into dynamic movements. We focus on retraining transitions and taking appropriate steps. Fine tuning those movements are very important. Lastly, we focus on rebuilding the stabilizers to the spine to prevent future injuries.