Subacute Posttraumatic Ascending Myelopathy After an Incomplete Spinal Cord Injury from a Gunshot Wound to the Spine: Case Report and Review of the Literature

Response to comment on subacute post-traumatic ascending myelopathy: a literature review

“…In the case from Dr Miller & Dr Ahmad, SPAM developed in a young man after mild spinal cord injury by gunshot, 1 which is similar to Dr Visocchi's case who had no neurological dysfunction after a neck gunshot injury, but unfortunately neurological deterioration occurred after 9 h. 2 A different mechanism of injury may exist in gunshot injury.…”

“…We are glad to hear that Dr Miller & Dr Ahmad show great interest in our review: Subacute post-traumatic ascending myelopathy: a literature review. 1 As many articles have mentioned, subacute post-traumatic ascending myelopathy (SPAM) is defined as neurological deterioration involving four or more vertebral segments above the initial injured site within the first few weeks. In our case, we suspect that a durotomy was indicated for improving respiratory failure caused by ascending myelopathy.…”

Subacute Posttraumatic Ascending Myelopathy After Thoracolumbar Spinal Cord Injury

“…Motor vehicle accidents (MVAs) were found to be the most common mode of injury. Cases were reported with SPAM due to gunshot injury as well 7,10,17,20 . SPAM was seen more commonly in cases who had fracture/dislocation with a complete SCI, indicating its association with the severity of the initial injury.…”

“…Hence, we performed an extensive literature review for this entity and analyzed 23 published articles reporting SPAM to date 2,5-25 . Only 29 cases of SPAM in patients with thoracolumbar (TL) trauma were found.…”

Subacute Posttraumatic Ascending Myelopathy

“…Hence, we reviewed the existing literature on this rare entity to elucidate and analyze SPAM. We found only 28 cases of SPAM after thoracolumbar injury that were reported in the literature 2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] . We report a case of SPAM occurring after T11/12 fracture-dislocation with rapid ascent of neurological level with sudden worsening after surgery.…”