White Cord Syndrome Following Long Posterior Decompression

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Ischemia/reperfusion injury can cause significant tissue damage.
• Decompressive spinal surgery carries a risk of spinal cord reperfusion injury.
• White cord syndrome (WCS) is a specific form of neurological deterioration post-spinal surgery.

Observation:

• A 63-year-old male with severe cervical myelopathy underwent posterior instrumented decompression.
• Post-operatively, the patient experienced neurological deterioration.
• Cervical spinal cord edema was identified on MRI, consistent with WCS.

Findings:

• The patient presented with neurological decline following spinal decompression.
• MRI revealed extensive cervical cord edema, indicative of white cord syndrome.
• No implant malposition was identified as a cause.

Implications:

• White cord syndrome must be considered in unexplained neurological deterioration after spinal surgery.
• Spine surgeons should counsel patients on the risks of WCS pre-operatively.
• Further research is needed to elucidate the exact mechanisms and treatments for WCS.