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

Abstract

<jats:p>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.</jats:p>

Subacute posttraumatic ascending myelopathy: a literature review

“…In the past 20 years, with the development of MRI techniques, SPAM has been gradually recognised and more surgeons have reported cases of SPAM and described its characteristics of clinical manifestation and radiological examinations. 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 …”

“…11 Mortality aside, the relative morbidity associated with SPAM is also high, with many survivors requiring prolonged hospitalisation and even mechanical ventilation. 1, 2, 3, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17 …”

“…The age distribution of SPAM is shown in Table 2. 1, 2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 Typically, young and middle-aged patients comprise the majority of this disorder, accounting for 90.6% (29/32). In addition, there is a significant sex-related difference in SPAM; males are more likely to suffer from SPAM, and the ratio of males to females is approximately 5:1 (27:5).…”

“…Here we present a literature review of 33 patients with SPAM by reviewing 13 published articles 1, 2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 (Table 1) including the epidemiology, aetiological mechanism, pathological study, clinical and radiological evaluation, treatment and prognosis.…”

Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy

“…A number of conservative interventions, including close observation, maintaining normal blood pressure, anticoagulation, antiapoptotic treatment, physical therapy, steroids and osmolar treatments have been carried out. 1,[3][4][5][6][7] Slight neurological improvement can occur over time in the majority of cases; however, none of these patients return to their baseline level of functioning. Unfortunately, in our case, conservative therapy could not improve SPAM, and the patient had a progressive neurological deterioration for which ventilatory support was required.…”