1st April 2022

A 70-year-old man presents to A&E with sudden onset upper back pain

A 70-year-old man presents to A&E with sudden onset upper back pain and bilateral leg weakness. These symptoms came on suddenly around six or seven hours ago, with no associated trauma, and have worsened to the point that he now cannot stand.  He has not passed urine since that morning, and a bladder scan shows 550ml in his bladder. An urgent MRI spine confirms a diagnosis of anterior spinal artery syndrome, affecting the cervical region. The patient is hypotensive with a systolic blood pressure ranging between 80 and 90 mmHg, and is resuscitated with intravenous fluids. High dose aspirin is administered with PPI cover. 

What additional intervention is required at this point?

Select the SINGLE most appropriate option from the list below. Select ONE option only.