A case report: white cord syndrome following anterior cervical discectomy and fusion: importance of prompt diagnosis and treatment.
Cervical Vertebrae
/ surgery
Diskectomy
/ adverse effects
Female
Humans
Intervertebral Disc Displacement
/ surgery
Magnetic Resonance Imaging
Middle Aged
Neck Pain
/ etiology
Paraplegia
/ etiology
Postoperative Complications
/ diagnostic imaging
Spinal Cord Compression
/ etiology
Spinal Cord Ischemia
/ diagnostic imaging
Spinal Fusion
/ adverse effects
Syndrome
Cervical
Fusion
Huge disc, discectomy
White cord syndrome
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
12 Mar 2020
12 Mar 2020
Historique:
received:
07
05
2019
accepted:
24
02
2020
entrez:
14
3
2020
pubmed:
14
3
2020
medline:
29
12
2020
Statut:
epublish
Résumé
Objective: White cord syndrome is extremely rare and search of the literature has revealed very few cases. Postoperative MR scan revealed hyperintense intrinsic cord signal changes within cord ischemia and edema. It is thought to be caused by reperfusion injury of the spinal cord. This is called white cord syndrome. This report is very rare case of 'White Cord Syndrome' with paraplegia after anterior cervical discectomy and fusion (ACDF). A 49-year-old woman presented with neck pain lasting for several months and second and third finger radiating pain. Severe cervical herniated intervertebral disc findings could be identified at C6-7 level on C-spine MRI. ACDF C6-7 surgery was performed. Immediately after the operation, physical examination revealed paraplegia and emergency MRI was performed. On MR images, T2 high signal myelopathy suspected as reperfusion injury at C6-7 level, and emergency surgery was performed under diagnosis of white cord syndrome. After the emergency operation, the paraplegic problem was gradually resolved. Before discharge, motor power and sensory deficit of bilateral lower extremity were fully recovered. Surgeons should explain the possibility of white cord syndrome before cervical decompression surgery and should perform a neurological examination immediately after surgery. We recommend that the importance of early recognition and prompt treatment of white cord syndrome.
Sections du résumé
BACKGROUND
BACKGROUND
Objective: White cord syndrome is extremely rare and search of the literature has revealed very few cases. Postoperative MR scan revealed hyperintense intrinsic cord signal changes within cord ischemia and edema. It is thought to be caused by reperfusion injury of the spinal cord. This is called white cord syndrome. This report is very rare case of 'White Cord Syndrome' with paraplegia after anterior cervical discectomy and fusion (ACDF).
CASE PRESENTATION
METHODS
A 49-year-old woman presented with neck pain lasting for several months and second and third finger radiating pain. Severe cervical herniated intervertebral disc findings could be identified at C6-7 level on C-spine MRI. ACDF C6-7 surgery was performed. Immediately after the operation, physical examination revealed paraplegia and emergency MRI was performed. On MR images, T2 high signal myelopathy suspected as reperfusion injury at C6-7 level, and emergency surgery was performed under diagnosis of white cord syndrome. After the emergency operation, the paraplegic problem was gradually resolved. Before discharge, motor power and sensory deficit of bilateral lower extremity were fully recovered.
CONCLUSION
CONCLUSIONS
Surgeons should explain the possibility of white cord syndrome before cervical decompression surgery and should perform a neurological examination immediately after surgery. We recommend that the importance of early recognition and prompt treatment of white cord syndrome.
Identifiants
pubmed: 32164644
doi: 10.1186/s12891-020-3162-3
pii: 10.1186/s12891-020-3162-3
pmc: PMC7066844
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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