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Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation

A C Planner1, P M Pretorius, A Graham

  • 1Department of Radiology, John Radcliffe Hospital, Oxford, UK. andyplanner@htmail.com

Spinal Cord
|April 5, 2007
PubMed
Abstract

Insights

Subacute progressive ascending myelopathy (SPAM) is a rare complication of spinal cord injury, characterized by specific MRI findings and potential neurological deterioration. While some patients improve, SPAM can be fatal.

Area of Science:

  • Neurology
  • Radiology
  • Spinal Cord Injury Research

Background:

  • Subacute progressive ascending myelopathy (SPAM) is a rare but serious complication following spinal cord injury.
  • Understanding its clinical presentation and imaging features is crucial for diagnosis and management.

Purpose of the Study:

  • To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of SPAM.
  • To identify characteristic MRI findings associated with SPAM.

Main Methods:

  • Retrospective case review of 11 patients with typical MRI features of SPAM.
  • Analysis of case notes and MRI studies from a tertiary Spinal Injuries centre over 15 years.

Main Results:

  • Eleven patients presented with SPAM a median of 13 days post-cord injury, involving a median of 6 cord segments.
  • Characteristic MRI findings included cord expansion, increased intramedullary T2 signal, and peripheral cord sparing.
  • Neurological deficits improved but did not fully resolve; mortality was 9%.

Conclusions:

  • SPAM is a rare cause of neurological deterioration after spinal cord injury, with distinct MRI appearances.
  • Clinical presentation varies, including neurological decline, shoulder pain, respiratory issues, or being subclinical.
  • SPAM can be fatal, highlighting the need for prompt recognition and management.

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