A 69-Year-Old Man Is Evaluated Shortly After Undergoing Elective Surgical

A 69-year-old man is evaluated shortly after undergoing elective surgical repair of a descending thoracic aortic aneurysm.  He has weakness in both lower extremities and urinary retention, which were not present before the procedure.  The surgery was complicated by significant blood loss requiring multiple transfusions.  The patient has a history of osteoarthritis, hypertension, hyperlipidemia, type 2 diabetes mellitus, and coronary artery disease.  He also has 70% stenosis of his right carotid artery.  Neurologic examination shows flaccid paralysis and loss of pain sensation in the lower extremities; vibratory sensation is intact.  Upper extremity examination reveals no abnormalities.  Which of the following is the most likely cause of this patient's neurologic dysfunction?

A) Cervical spondylotic myelopathy
B) Epidural hematoma compressing the spinal cord
C) Intraoperative cortical stroke
D) Lumbar plexopathy
E) Spinal cord infarction

Correct Answer:

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