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Subacute Progressive Ascending Myelopathy from L2 to C4 after A Burst Fracture of the Second Lumbar Vertebra

Abstract

Sylvia Farzi, Gernot Wildner, Rainer Gumpert and Gerhard Prause

Subacute progressive ascending myelopathy is a rare, poorly understood neurological complication of spinal cord injury, unrelated to mechanical compression, instability, or syrinx formation at the level of injury or above. To date, there is no known treatment for this dramatic spinal cord injury complication. We present a case of subacute progressive myelopathy after lumbar spine trauma. The therapy consisted of plasmapheresis, hyperbaric oxygen, high-dose cortisol, antibiotic, and antiviral drugs. At 1 year post injury, the patient had recovered most of his lost upper-extremity function and MRI demonstrated only discrete signal intensity alterations extending to T3/4.

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