The authors have analyzed 200 clinical cases of ischemic damage to the lower half of the spinal cord secondary to surgery-verified hernia of a lumbar intervertebral disk. In many patients the surgical findings, in addition to a compressed spinal radicle, included compression of an arterial or a venous vessel. Clinical characteristics were compared in patients with compression of the radiculo-medullar artery (n = 100) and of the large radicular vein (n = 100). Significant for the differential diagnosis are the rate of myeloischemia evolution, characteristics and the time-course of the pain syndrome, the composition of the cerebrospinal fluid and the topography of ischemia in the transverse section of the spinal cord. The necessity of differentiating between arterial and venous radiculomyeloischemia is dictated by the advisability of the inclusion into the therapeutic complex of special vasoactive drugs (improving the arterial blood flow) or venotonics. Indications for the surgical treatment of such patients are presented.
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