Subacute posttraumatic ascending myelopathy: a literature review
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Published on: September 18, 2011
Study Design:
A literature review.
Objectives:
Our aim was to summarise the history, epidemiology, aetiological mechanism, pathological study, clinical and radiological evaluation, treatment and prognosis of subacute posttraumatic ascending myelopathy (SPAM).
Methods:
Medical literature on SPAM were searched in the PubMed, Medline, Ovid and Embase databases. The cases of SPAM reported in literature were analysed, and the history, epidemiology, aetiological mechanism, pathological study, clinical and radiological evaluation, treatment and prognosis of SPAM were summarised.
Results:
SPAM remains a relatively rare disorder occurring within the first few weeks after spinal cord injury (SCI). The incidence rate ranges from 0.42% to 1% among all SCI. SPAM is likely to occur in young and middle-aged male patients. Risk factors of SPAM include complete injury, low blood pressure, early postoperative mobilisation and nonsurgical treatment.
Conclusions:
SPAM is well recognised according to typical clinical manifestation and magnetic resonance imaging characteristics. There is no effective therapy for this neurological deterioration. The prognosis of SPAM is poor. There is usually a slight improvement of one or more level(s) below the maximal level of deterioration. The mortality rate is approximately 10%.
Insights
Subacute posttraumatic ascending myelopathy (SPAM) is a rare complication of spinal cord injury (SCI). Currently, there is no effective treatment, and the prognosis is poor, with a 10% mortality rate.
Area of Science:
- Neurology
- Neurosurgery
- Spinal Cord Injury Research
Background:
- Subacute posttraumatic ascending myelopathy (SPAM) is a rare but serious neurological complication following spinal cord injury (SCI).
- Understanding the history, epidemiology, and pathophysiology of SPAM is crucial for improving patient outcomes.
- This condition presents unique diagnostic and therapeutic challenges.
Purpose of the Study:
- To comprehensively review the existing literature on SPAM.
- To summarize the history, epidemiology, etiology, pathology, clinical and radiological features, treatment, and prognosis of SPAM.
- To provide a consolidated resource for clinicians and researchers investigating this rare disorder.
Main Methods:
- A systematic literature review was conducted using major medical databases (PubMed, Medline, Ovid, Embase).
- Cases of SPAM reported in the literature were analyzed.
- Key aspects including history, epidemiology, etiology, pathology, clinical presentation, radiological findings, treatment strategies, and prognosis were extracted and summarized.
Main Results:
- SPAM is a rare disorder, occurring in 0.42% to 1% of SCI cases, typically within weeks of injury.
- Young to middle-aged males are more commonly affected. Risk factors include complete SCI, hypotension, early mobilization, and non-surgical management.
- SPAM is characterized by specific clinical and MRI findings.
Conclusions:
- SPAM is recognizable through clinical and MRI characteristics.
- Currently, no effective therapies exist for this neurological deterioration, leading to a poor prognosis.
- While some minor improvement below the maximal deterioration level may occur, the mortality rate is approximately 10%.
