White Cord Syndrome: A Reperfusion Injury Following Spinal Decompression Surgery

Reperfusion injury of the spinal cord has been scarcely reported. Herein, we present a case of white cord syndrome after spinal decompression. A 61-year-old male, who initially had ossification of the posterior longitudinal ligament at C3-6 level, was admitted to our hospital with a ruptured disc at the C6-7 level. The patient experienced radiating pain in both upper extremities. Anterior cervical discectomy and fusion was performed. However, the patient developed quadriplegia. Emergency magnetic resonance imaging revealed a new and enlarged signal change in the spinal cord at the C4-7 level. Additional posterior decompression surgery was performed. After intense rehabilitation, the patient's motor function improved to grade 4. White cord syndrome is likely due to reperfusion injury following operative decompression of a compressed spinal cord segment. Although rare, spine surgeons should be aware of this complication and warn patients preoperatively.