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Resolution of SPAM following cordectomy: implications for understanding pathophysiology
T M Meagher1, M Belci, L López de Heredia
1Department of Radiology, National Spinal Injuries Center, Stoke Mandeville Hospital, Buckinghamshire, UK. tom.meagher@buckshealthcare.nhs.uk
Study Design:
Case report.
Objective:
To describe the clinical benefit of a spinal cordectomy with the aim of limiting neurological deterioration related to the development of a subacute posttraumatic ascending myelopathy (SPAM) supporting previously described mechanism for SPAM formation.
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.
Method And Results:
A 38-year old patient presented 6 months after spinal cord injury substantial neurological deterioration expanding from the initial T4-injury level through C4. Magnetic resonance imaging revealed intra-medullary haemorrhage at the site of injury and subsequent-ascending cord oedema. A cordectomy was performed leading to neurological stabilisation and complete resolution of SPAM.
Conclusion:
Cordectomy can be an effective intervention in case of rapid progressive neurological deterioration.
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