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Surfer's myelopathy: an atypical case presentation.
Courtney Gilbert1,2, Steven Kirshblum3,4, Amanda Miller4
1Rutgers New Jersey Medical School, Newark, NJ, USA. cg792@njms.rutgers.edu.
Spinal Cord Series and Cases
|June 7, 2020
Summary
Surfer's myelopathy (SM) can occur in older individuals, challenging typical diagnostic criteria. This case highlights the need for thorough evaluation beyond initial MRI findings in suspected SM.
Area of Science:
- Neurology
- Sports Medicine
- Spinal Cord Injury
Background:
- Surfer's myelopathy (SM) is a rare spinal cord injury typically affecting younger individuals (<40 years) after activities involving prolonged lumbar hyperextension.
- Initial magnetic resonance imaging (MRI) in SM cases usually reveals T2 signal abnormalities in the spinal cord.
Observation:
- A 43-year-old male, new to surfing, presented with back pain and progressive lower extremity numbness and weakness.
- Initial MRI, performed 11-12 hours post-symptom onset, showed no T2 signal abnormalities, deviating from the typical SM presentation.
Findings:
- The patient's initial neurological classification was T12 American Spinal Injury Association Impairment Scale (AIS) A.
- After 6 weeks of rehabilitation, his classification improved to T12 AIS B.
Implications:
- This case demonstrates that SM can occur in individuals over 40 and may not present with initial MRI T2 signal abnormalities.
- Emphasizes the importance of comprehensive clinical history and physical examination for diagnosing atypical SM presentations.
- Highlights the need for increased awareness among surfing instructors, trainees, and healthcare providers for early SM detection.
