Subacute posttraumatic ascending myelopathy in a 15-year-old boy

Case report

Timothy J. Kovanda M.D. and Eric M. Horn M.D., Ph.D.
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  • Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
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Secondary injury following initial spinal cord trauma is uncommon and frequently attributed to mismanagement of an unprotected cord in the acute time period after injury. Subacute posttraumatic ascending myelopathy (SPAM) is a rare occurrence in the days to weeks following an initial spinal cord injury that is unrelated to manipulation of an unprotected cord and involves 4 or more vertebral levels above the original injury. The authors present a case of SPAM occurring in a 15-year-old boy who sustained a T3–4 fracture-dislocation resulting in a complete spinal cord injury, and they highlight the imaging findings and optimum treatment for this rare event.

Abbreviation used in this paper:

SPAM = subacute posttraumatic ascending myelopathy.

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  • 1

    Aito S, , El Masry WS, , Gerner HJ, , Lorenzo ND, , Pellicanò G, & D'Andrea M, et al.: Ascending myelopathy in the early stage of spinal cord injury. Spinal Cord 37:617623, 1999

    • Search Google Scholar
    • Export Citation
  • 2

    Al-Ghatany M, , Al-Shraim M, , Levi AD, & Midha R: Pathological features including apoptosis in subacute posttraumatic ascending myelopathy. Case report and review of the literature. J Neurosurg Spine 2:619623, 2005

    • Search Google Scholar
    • Export Citation
  • 3

    Belanger E, , Picard C, , Lacerte D, , Lavallee P, & Levi AD: Subacute posttraumatic ascending myelopathy after spinal cord injury. Report of three cases. J Neurosurg 93:2 Suppl 294299, 2000

    • Search Google Scholar
    • Export Citation
  • 4

    Colterjohn NR, & Bednar DA: Identifiable risk factors for secondary neurologic deterioration in the cervical spine-injured patient. Spine (Phila Pa 1976) 20:22932297, 1995

    • Search Google Scholar
    • Export Citation
  • 5

    Crowe MJ, , Bresnahan JC, , Shuman SL, , Masters JN, & Beattie MS: Apoptosis and delayed degeneration after spinal cord injury in rats and monkeys. Nat Med 3:7376, 1997

    • Search Google Scholar
    • Export Citation
  • 6

    Farmer J, , Vaccaro A, , Albert TJ, , Malone S, , Balderston RA, & Cotler JM: Neurologic deterioration after cervical spinal cord injury. J Spinal Disord 11:192196, 1998

    • Search Google Scholar
    • Export Citation
  • 7

    Frankel HL: Ascending cord lesion in the early stages following spinal injury. Paraplegia 7:111118, 1969

  • 8

    Harrop JS, , Sharan AD, , Vaccaro AR, & Przybylski GJ: The cause of neurologic deterioration after acute cervical spinal cord injury. Spine (Phila Pa 1976) 26:340346, 2001

    • Search Google Scholar
    • Export Citation
  • 9

    Klekamp J: Treatment of posttraumatic syringomyelia. Clinical article. J Neurosurg Spine 17:199211, 2012

  • 10

    Kumar A, , Kumar J, , Garg M, , Farooque K, , Gamanagatti S, & Sharma V: Posttraumatic subacute ascending myelopathy in a 24-year-old male patient. Emerg Radiol 17:249252, 2010

    • Search Google Scholar
    • Export Citation
  • 11

    Lee TT, , Arias JM, , Andrus HL, , Quencer RM, , Falcone SF, & Green BA: Progressive posttraumatic myelomalacic myelopathy: treatment with untethering and expansive duraplasty. J Neurosurg 86:624628, 1997

    • Search Google Scholar
    • Export Citation
  • 12

    Lu J, , Ashwell KW, & Waite P: Advances in secondary spinal cord injury: role of apoptosis. Spine (Phila Pa 1976) 25:18591866, 2000

  • 13

    Marshall LF, , Knowlton S, , Garfin SR, , Klauber MR, , Eisenberg HM, & Kopaniky D, et al.: Deterioration following spinal cord injury. A multicenter study. J Neurosurg 66:400404, 1987

    • Search Google Scholar
    • Export Citation
  • 14

    Meagher TM, , Belci M, , López de Heredia L, , Ansorge O, , Jamous A, & Saif M, et al.: Resolution of SPAM following cordectomy: implications for understanding pathophysiology. Spinal Cord 50:638640, 2012

    • Search Google Scholar
    • Export Citation
  • 15

    Planner AC, , Pretorius PM, , Graham A, & Meagher TM: Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation. Spinal Cord 46:140144, 2008

    • Search Google Scholar
    • Export Citation
  • 16

    Schmidt BJ: Subacute delayed ascending myelopathy after low spine injury: case report and evidence of a vascular mechanism. Spinal Cord 44:322325, 2006

    • Search Google Scholar
    • Export Citation
  • 17

    Yablon IG, , Ordia J, , Mortara R, , Reed J, & Spatz E: Acute ascending myelopathy of the spine. Spine (Phila Pa 1976) 14:10841089, 1989

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