Resolution of SPAM following cordectomy: implications for understanding pathophysiology

Spinal Cord. 2012 Aug;50(8):638-40. doi: 10.1038/sc.2011.133. Epub 2011 Dec 13.

Abstract

Study design: Case report.

Objective: To describe the clinical benefit of a spinal cordectomy with the aim of limiting neurological deterioration related to the development of a subacute posttraumatic ascending myelopathy (SPAM) supporting previously described mechanism for SPAM formation.

Setting: National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.

Method and results: A 38-year old patient presented 6 months after spinal cord injury substantial neurological deterioration expanding from the initial T4-injury level through C4. Magnetic resonance imaging revealed intra-medullary haemorrhage at the site of injury and subsequent-ascending cord oedema. A cordectomy was performed leading to neurological stabilisation and complete resolution of SPAM.

Conclusion: Cordectomy can be an effective intervention in case of rapid progressive neurological deterioration.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Hemorrhage / complications
  • Hemorrhage / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / surgery*
  • Treatment Outcome