Non-traumatic anterior spinal cord infarction in a novice surfer: a case report

We present a case involving a 24-year-old woman who developed anterior spinal cord infarction with paraplegia but preserved posterior column sensation shortly after her first surfing lesson. The clinical presentation and magnetic resonance imaging findings were compatible with anterior cord infarction from T11 to conus medullaris. However, a thorough diagnostic workup revealed no predisposing factors of ischemia. Like previously reported cases of surfer's myelopathy, our patient was inexperienced and lacked trained back muscles, though none of the previously related cases were reported to have anterior cord infarction. In this case report, we discuss the probable relationship between surfing and ischemic myelopathy. Non-traumatic myelopathy in surfing is a relatively new entity thought to occur in surfers while paddling their boards in a hyperextended position and perform the Valsalva maneuver while attempting to stand up on the boards, which may increase intra-spinal pressure. Increased awareness of this injury may make it possible to recognize its early symptoms and prevent further injury.