“White Cord Syndrome” of Acute Hemiparesis After Posterior Cervical Decompression and Fusion for Chronic Cervical Stenosis

Publication date: May 2018
Source:World Neurosurgery, Volume 113
Author(s): Prince Antwi, Ryan Grant, Gregory Kuzmik, Khalid Abbed
Background"White cord syndrome" is a very rare condition thought to be due to acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted magnetic resonance imaging sequences in a patient with unexplained neurologic deficits following spinal cord decompression surgery. The syndrome is rare and has been reported previously in 2 patients following anterior cervical decompression and fusion. We report an additional case of this complication.Case DescriptionA 68-year-old man developed acute left-sided hemiparesis after posterior cervical decompression and fusion for cervical spondylotic myelopathy. The patient improved with high-dose steroid therapy.ConclusionsThe rare white cord syndrome following either anterior cervical decompression and fusion or posterior cervical decompression and fusion may be due to ischemic-reperfusion injury sustained by chronically compressed parts of the spinal cord. In previous reports, patients have improved following steroid therapy and acute rehabilitation.



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