What are the other Names for this Condition? (Also known as/Synonyms)

• FCE (Fibrocartilaginous Embolism)

What is Fibrocartilaginous Embolism? (Definition/Background Information)

• Fibrocartilaginous Embolism (FCE) is a rare type of embolism (sudden blocking of an artery) that occurs in the spinal cord
• FCE occurs when materials that are usually found within the vertebral disc of the spine enter into the nearby vascular system (veins and arteries) and block one of the spinal cord vessels
• The signs and symptoms of Fibrocartilaginous Embolism often develop after a minor or even unnoticed “triggering event” such as lifting, straining, or falling. Symptoms of FCE may include neck and/or back pain, progressive muscle weakness, and paralysis
• The exact underlying cause of Fibrocartilaginous Embolism is poorly understood. Most cases occur sporadically in people with no family history of the disease
• Diagnosis is based on imaging of the spinal cord and ruling out other causes of a blockage of the vascular system within the spinal cord. Treatment is generally focused on preventing possible complications and improving quality of life with medications and physical therapy

(Source: Fibrocartilaginous Embolism; Genetic and Rare Diseases Information Center (GARD) of National Center for Advancing Translational Sciences (NCATS), USA.)

Who gets Fibrocartilaginous Embolism? (Age and Sex Distribution)

• Fibrocartilaginous Embolism is a rare disorder that may affect individuals of any age. However, individuals in their late teens-20s, and in their 60s are more susceptible to the disorder
• Both genders may be affected, although the condition is more common in females
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Fibrocartilaginous Embolism? (Predisposing Factors)

The risk factors for Fibrocartilaginous Embolism may include:

• Female gender
• Teens and older adults (over 60 years)
• Lifting heavy weights, leading to back strain 
• Unnatural twisting or jerky movement
• Falls and injuries
• Accidents that may have caused injury to the spinal cord in the past
• Osteoporosis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fibrocartilaginous Embolism? (Etiology)

• Fibrocartilaginous Embolism (FCE) is caused when materials that are usually found within the vertebral disc of the spine migrate into the nearby vascular system (veins and arteries) and block one of the spinal cord vessels. The exact cause of this migration is unclear, but symptoms often occur after a minor trauma
• The vasculature in the spinal cord regresses as individuals enter young adulthood, and the vasculature increases again as people enter their 60s. Therefore, FCE is more likely to occur when there are more blood vessels located in and around the spinal cord
• Some causes of FCE are thought to include aging, people who have fibrocartilaginous material (Schmorl nodes) built up in the vertebrae, or people who have spinal cord vasculature that is present throughout adulthood

(Source: Fibrocartilaginous Embolism; Genetic and Rare Diseases Information Center (GARD) of National Center for Advancing Translational Sciences (NCATS), USA.)

What are the Signs and Symptoms of Fibrocartilaginous Embolism?

The signs and symptoms of Fibrocartilaginous Embolism may include:

• Sudden neck and/or back pain
• Progressive muscle weakness
• Bladder and/or bowel dysfunction
• Paralysis

In the majority of cases, FCE develops after a minor or even unnoticed "triggering event" such as a minor head or neck injury or heavy lifting. The amount of time between the "trigger" and the onset of symptoms varies from minutes to days, with the average onset of symptoms being 2-4 days after the triggering incident.

(Source: Fibrocartilaginous Embolism; Genetic and Rare Diseases Information Center (GARD) of National Center for Advancing Translational Sciences (NCATS), USA.)

How is Fibrocartilaginous Embolism Diagnosed?

A diagnosis of Fibrocartilaginous Embolism is generally suspected based on the presence of characteristic signs and symptoms. Other conditions that cause similar features can be ruled out using the following tests:

• Imaging of the spine with CT scan or MRI scan
• Cerebral spinal fluid (CSF collection)

(Source: Fibrocartilaginous Embolism; Genetic and Rare Diseases Information Center (GARD) of National Center for Advancing Translational Sciences (NCATS), USA.)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fibrocartilaginous Embolism?

The complications of Fibrocartilaginous Embolism may include:

• Severe pain
• Paralysis and problems with mobility

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Fibrocartilaginous Embolism Treated?

There is no specific treatment for Fibrocartilaginous Embolism, and treatment methods are geared toward symptom management and preventing complications. The treatment options may include:

• Physiotherapy
• Use of steroids
• Pain medication
• Surgery
• Heparin administration and/or blood pressure control

How can Fibrocartilaginous Embolism be Prevented?

• It may be possible to prevent Fibrocartilaginous Embolism by considering the following measures:
  • Avoiding sudden twisting or jerky movements
  • Using proper technique for heavy lifting, using braces to support the weight
  • Seeking medical attention for unusual back pain
• Active research is currently being performed to explore the possibilities for treatment and prevention of disorders such as Fibrocartilaginous Embolism

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

What is the Prognosis of Fibrocartilaginous Embolism? (Outcomes/Resolutions)

• The long-term outlook (prognosis) for people affected by Fibrocartilaginous Embolism was once thought to be extremely poor with little hope for improvement of symptoms
• However, more recent research has challenged this assumption. Many researchers now believe that there is a much wider spectrum of the severity and recovery associated with FCE. Researchers also suspect that the length and degree of recovery depends on many factors including:
  • The location of FCE along the spinal cord
  • The extent of spinal cord ischemia (restriction of blood supply to organs or tissues)

(Source: Fibrocartilaginous Embolism; Genetic and Rare Diseases Information Center (GARD) of National Center for Advancing Translational Sciences (NCATS), USA.)

Additional and Relevant Useful Information for Fibrocartilaginous Embolism:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/