Surfer’s myelopathy: an atypical case presentation

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-020-0297-2 · Published: June 1, 2020

Spinal Cord Injury Neurology Orthopedics

Simple Explanation

Surfer’s myelopathy (SM) is a rare nontraumatic spinal cord injury seen in beginner surfers and people participating in activities involving prolonged lumbar hyperextension. The majority of cases of SM have been reported in younger patients under 40 years of age, with initial magnetic resonance imaging (MRI) showing T2 signal abnormalities. This paper presents a case of SM in a person over 40 years old whose initial MRI did not show the T2 signal abnormalities usually reported in SM.

Study Duration

Not specified

Participants

A 43-year-old male

Evidence Level

Case report

Key Findings

1
A 43-year-old male developed symptoms consistent with Surfer's Myelopathy after surfing for the first time, but initial MRI did not show typical T2 signal abnormalities.
2
The patient initially presented with T12 American Spinal Injury Association Impairment Scale (AIS) A and improved to T12 AIS B after 6 weeks of rehabilitation.
3
This case highlights the importance of considering SM even when initial MRI findings are negative and emphasizes the role of thorough clinical history and physical examination in diagnosis.

Research Summary

This case report describes an atypical presentation of Surfer's Myelopathy (SM) in a 43-year-old male, highlighting that SM can occur in older individuals and without the typical T2 signal abnormalities on initial MRI. The patient's condition improved from AIS A to AIS B after rehabilitation, demonstrating the potential for functional recovery even in cases with unusual presentations. The authors emphasize the need for increased awareness of SM among instructors, trainees, and healthcare providers to facilitate early identification and appropriate management, regardless of MRI findings.

Practical Implications

Diagnostic Considerations

Clinicians should consider Surfer's Myelopathy even in the absence of typical MRI findings, relying on clinical history and physical examination.

Rehabilitation Strategies

Patients with SM, regardless of initial presentation, may benefit from comprehensive rehabilitation programs to improve functional independence.

Preventive Education

Surfing instructors should educate trainees on proper seated form and early warning signs to minimize the risk of SM.

Study Limitations

1
Single case report limits generalizability.
2
Lack of follow-up MRI data to assess delayed T2 signal changes.
3
Limited information on specific mechanisms of injury in this atypical presentation.

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