Late‑onset white cord syndrome following anterior cervical discectomy and fusion: A case report

White cord syndrome refers to an emerging neurological dysfunction occurring after spinal decompression surgery with hyperenhancing changes on T2-weighted magnetic resonance imaging (T2WI). The pathophysiological mechanism is hypothesized to be an ischemia-reperfusion injury following chronic ischem...

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Bibliographic Details
Published in:Experimental and therapeutic medicine 2023-01, Vol.25 (1), Article 71
Main Authors: Lei, Chang-Zhen, Gong, Dao-Jun, Zhou, Yang-Fan
Format: Article
Language:English
Subjects:
Back surgery
Care and treatment
Case Report
Case reports
Case studies
Complications and side effects
Diagnosis
Discectomy
Drug dosages
Edema
Free radicals
Hematoma
Ischemia
Magnetic resonance imaging
Paralysis
Patients
Spinal cord injuries
Steroids
Trauma
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Summary:White cord syndrome refers to an emerging neurological dysfunction occurring after spinal decompression surgery with hyperenhancing changes on T2-weighted magnetic resonance imaging (T2WI). The pathophysiological mechanism is hypothesized to be an ischemia-reperfusion injury following chronic ischemic spinal cord decompression. A 54-year-old man was admitted to Jinhua Municipal Central Hospital with complaints of numbness and weakness in the extremities and swelling in the neck. MRI showed degeneration and herniation of the C4-C7 intervertebral discs. The patient underwent anterior cervical corpectomy and fusion (ACCF). On the 7th postoperative day, the patient reappeared with weakness of the limbs. Physical examination revealed paralysis. Emergency MRI suggested T2 high signal myelopathy and emergency surgery was performed following the diagnosis of white cord syndrome. Following the operation, the patient's neurological system gradually improved. The motor ability and sensory function of the extremities recovered at 7-month follow-up. Spine surgeons should be aware of this serious complication. The present case serves to provide experience for clinical treatment and diagnosis and encourage research into its pathophysiology.
ISSN:1792-0981
1792-1015
DOI:10.3892/etm.2022.11770