Kaya Ozcan, Erdogan Sinan, Ozkunt Okan, Kaya Ebru, Ozturk Cagatay
Istanbul Training and Research Hospital, Istanbul, Turkey.
Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Br J Neurosurg. 2023 Oct;37(5):1211-1214. doi: 10.1080/02688697.2020.1834512. Epub 2020 Oct 19.
Subacute post-traumatic ascending myelopathy (SPAM) is a rare complication after spinal cord injury (SCI). SPAM onsets within few days or weeks after initial SCI. Here, we present an adolescent male athlete who developed SPAM after SCI and brief review of literature. Previous reports almost all were about adult patients. Here, we present second adolescent case in the literature.
A 15 years old adolescent athlete presented to A&E with a T10-T11 fracture dislocation of the spine and a SCI. He underwent T9-L1 posterior instrumentation and decompression. On the 11th post injury, he complained numbness of the T4 dermatome and by the 14th day, he had become tetraplegia with paralysis of the arms and required ventilation. MRI revealed C3-T10 cord changes on T2 weighed images. He received high dose methylprednisolone for 3 weeks. At one-year follow up he had fully recovered arm motor power and improved light touch and pin prick sensation.
SPAM may occur in adolescents with a good prognosis. Our case is well example against for proposal of arterial hypothesis.
创伤后亚急性上升性脊髓病（SPAM）是脊髓损伤（SCI）后一种罕见的并发症。SPAM在初次SCI后的数天或数周内发病。在此，我们报告一名在SCI后发生SPAM的青少年男性运动员，并对相关文献进行简要回顾。既往报道几乎均为成年患者。在此，我们报告文献中第二例青少年病例。
一名15岁的青少年运动员因胸10 - 胸11脊柱骨折脱位及SCI就诊于急诊科。他接受了胸9 - 腰1后路内固定及减压手术。受伤后第11天，他主诉胸4皮节麻木，到第14天，他发展为四肢瘫，双臂麻痹，需要通气支持。磁共振成像（MRI）在T2加权像上显示颈3 - 胸10脊髓改变。他接受了3周的大剂量甲泼尼龙治疗。在1年的随访中，他的手臂运动力量完全恢复，轻触觉和针刺觉有所改善。
SPAM可能发生于青少年，预后良好。我们的病例是反对动脉假说的一个很好例证。
