Abstract:A 46 years female sustained post-traumatic paraplegia with burst-fracture L1, with ASIA-A neurology, and underwent surgical decompression and stabilization. On 4 th post-operative day, patient developed ascending myelopathy with neurological deterioration upto C5, along with fever, neck rigidity, high counts, with MRI showing myelitis. An aggressive antibiotic therapy was started. Blood counts, fever and neck rigidity settled with a delayed partial neurological recovery at 17 weeks. Infection could not be confirmed as the cause of the ascending myelitis even though the patient responded to antibiotics. Ascending sympathetic myelitis was a differential, which though rare, is reported.
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