Posttraumatic syringomyelia associated with heavy weightlifting exercises: case report

Area of Science:

• Neurology
• Neurosurgery
• Rehabilitation Medicine

Background:

• Posttraumatic syringomyelia is a recognized complication following spinal cord injury (SCI).
• It affects 1-3.2% of SCI patients, presenting with pain, sensory loss, weakness, and reflex changes.
• The development of syringomyelia can significantly impact patient recovery and quality of life.

Observation:

• A 25-year-old male with C8 complete quadriplegia developed syringomyelia five years post-injury.
• The patient engaged in daily weightlifting exercises (50-60 lbs) involving neck extensors and biceps.
• This routine included repeated Valsalva maneuvers.

Findings:

• Clinical diagnosis of syringomyelia was confirmed by magnetic resonance imaging (MRI).
• The patient's strenuous weightlifting regimen, particularly the Valsalva maneuvers, is hypothesized as a contributing factor to syringomyelia development and expansion.
• Surgical placement of a subarachnoid shunt resulted in dramatic clinical improvement.

Implications:

• Heavy weightlifting and Valsalva maneuvers may pose risks for individuals with a history of SCI.
• Early diagnosis and appropriate surgical management are crucial for improving outcomes in posttraumatic syringomyelia.
• This case highlights the importance of considering patient activities in the context of SCI complications.