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

EXPERIMENTAL AND THERAPEUTIC MEDICINE, 2023 · DOI: 10.3892/etm.2022.11770 · Published: January 1, 2023

Neurology Surgery Research Methodology & Design

Simple Explanation

White cord syndrome (WCS) is a rare but serious complication that can occur after spinal decompression surgery, particularly in the cervical spine. It is thought to be caused by a sudden increase in blood flow to the spinal cord after it has been compressed for a long time, leading to injury. This case report describes a 54-year-old man who developed WCS a week after undergoing surgery for cervical spondylotic myelopathy (CSM). He experienced paralysis but gradually improved after further surgery and treatment. The authors emphasize the importance of surgeons being aware of WCS and considering it in patients who develop neurological deficits after cervical spine surgery. Early diagnosis and intervention are crucial for improving outcomes.

Study Duration

7 Months

Participants

One 54-year-old man

Evidence Level

Level 4, Case Report

Key Findings

1
The patient presented with late-onset WCS, developing paralysis on the 7th postoperative day after ACCF surgery for CSM.
2
Emergency MRI revealed T2 high intramedullary signal at the C5-C6 level, a characteristic finding in WCS.
3
The patient's neurological function gradually improved following a second surgery (posterior cervical decompression) and treatments including high-dose methylprednisolone and hyperbaric oxygen therapy.

Research Summary

This case report describes a patient who developed late-onset white cord syndrome (WCS) following anterior cervical corpectomy and fusion (ACCF) for cervical spondylotic myelopathy (CSM). The patient presented with paralysis one week after the initial surgery and was diagnosed with WCS based on clinical findings and MRI. He underwent further surgical decompression and medical management. The patient's neurological function improved after the second surgery and rehabilitation, highlighting the importance of early diagnosis and intervention for this rare but potentially devastating complication.

Practical Implications

Increased Awareness

Spine surgeons should be aware of WCS as a potential complication following cervical spine surgery.

Early Diagnosis and Intervention

Prompt diagnosis and intervention, including high-dose methylprednisolone and potentially further decompression surgery, are crucial for improving neurological outcomes.

Informed Consent

Surgeons should include WCS as a potential complication in the informed consent process prior to spinal surgery.

Study Limitations

1
Single case report limits generalizability
2
Insufficient number of cases limits the identification of specific WCS risk factors.
3
Further research is required to investigate the exact mechanism of WCS

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