Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Surfer's Myelopathy : Case Series and Literature Review

  • Choi, June Ho (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ha, Jung-Ki (Department of Orthopaedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Chung Hwan (Department of Orthopaedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Park, Jin Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2017.09.30
  • Accepted : 2018.03.05
  • Published : 2018.11.01
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Abstract

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

Keywords

References

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