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‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report

  • Authors:
    • Yu-Xin Liao
    • Shi-Sheng He
    • Zhi-Min He
  • View Affiliations / Copyright

    Affiliations: Department of Orthopaedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
    Copyright: © Liao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 90
    |
    Published online on: September 11, 2020
       https://doi.org/10.3892/etm.2020.9218
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Abstract

Transient paralysis following spinal decompression surgery is a rare but devastating postoperative complication. Spinal cord ischemia‑reperfusion injury has been identified as one of the crucial pathogenic factors contributing to the sudden neurological deterioration associated with spinal decompression surgery. ‘White cord syndrome’ is a characteristic imaging manifestation of spinal cord ischemia‑reperfusion injury, referring to high intramedullary signal changes in the sagittal T2‑weighted MRI scan with unexplained neurological deficits following surgical decompression. The present study reported on the case of a 51‑year old male patient who suffered from acute left limb hemiplegic paralysis following posterior cervical laminectomy decompression for severe cervical spondylotic myelopathy and spinal stenosis, which were caused by ossification of the posterior longitudinal ligament. The patient's neurological function gradually improved after the immediate administration of high‑dose methylprednisolone therapy combined with mannitol and neurotrophic drugs. At the 2‑month follow‑up, the intensity of the spinal cord signal on MRI had almost returned to normal and the ‘white cord syndrome’ had disappeared. However, the patient complained of postoperative neck swelling pain caused by cerebrospinal fluid leakage; therefore, an additional cerebrospinal fluid leakage exploration and neoplasty were performed. At 2 weeks after the second surgery, the patient's neck swelling pain was relieved and the area of cerebrospinal fluid leakage was significantly reduced. Despite the low incidence rate, surgeons should be aware of this complication, particularly when treating chronic severe cervical spinal stenosis with anterior or posterior decompression. Once transient paralysis occurs, early diagnosis and interventions are essential to reverse the neurological deficit.
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1 

Yang T, Wu L, Wang H, Fang J, Yao N and Xu Y: Inflammation level after decompression surgery for a rat model of chronic severe spinal cord compression and effects on ischemia-reperfusion injury. Neurol Med Chir (Tokyo). 55:578–586. 2015.PubMed/NCBI View Article : Google Scholar

2 

Chin KR, Seale J and Cumming V: ‘White cord syndrome’ of acute tetraplegia after anterior cervical decompression and fusion for chronic spinal cord compression: A case report. Case Rep Orthop. 2013(697918)2013.PubMed/NCBI View Article : Google Scholar

3 

Vinodh VP, Rajapathy SK, Sellamuthu P and Kandasamy R: White cord syndrome: A devastating complication of spinal decompression surgery. Surg Neurol Int. 9(136)2018.PubMed/NCBI View Article : Google Scholar

4 

Hu S, Dong HL, Li YZ, Luo ZJ, Sun L, Yang QZ, Yang LF and Xiong L: Effects of remote ischemic preconditioning on biochemical markers and neurologic outcomes in patients undergoing elective cervical decompression surgery: A prospective randomized controlled trial. J Neurosurg Anesthesiol. 22:46–52. 2010.PubMed/NCBI View Article : Google Scholar

5 

Young WF and Baron E: Acute neurologic deterioration after surgical treatment for thoracic spinal stenosis. J Clin Neurosci. 8:129–132. 2001.PubMed/NCBI View Article : Google Scholar

6 

Vanpee G, Hermans G, Segers J and Gosselink R: Assessment of limb muscle strength in critically ill patients: A systematic review. Crit Care Med. 42:701–711. 2014.PubMed/NCBI View Article : Google Scholar

7 

Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, Eisenberg HM, Flamm E, Leo-Summers L, Maroon J, et al: A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury Results of the Second National acute spinal cord injury study. N Engl J Med. 322:1405–1411. 1990.PubMed/NCBI View Article : Google Scholar

8 

Zhang JD, Xia Q, Ji N, Liu YC, Han Y and Ning SL: Transient paralysis shortly after anterior cervical corpectomy and fusion. Orthop Surg. 5:23–28. 2013.PubMed/NCBI View Article : Google Scholar

9 

Jiang X, Shi E, Nakajima Y and Sato S: Postconditioning, a series of brief interruptions of early reperfusion, prevents neurologic injury after spinal cord ischemia. Ann Surg. 244:148–153. 2006.PubMed/NCBI View Article : Google Scholar

10 

Back MR, Bandyk M, Bradner M, Cuthbertson D, Johnson BL, Shames ML and Bandyk DF: Critical analysis of outcome determinants affecting repair of intact aneurysms involving the visceral aorta. Ann Vasc Surg. 19:648–656. 2005.PubMed/NCBI View Article : Google Scholar

11 

Khan MF, Jooma R, Hashmi FA and Raghib MF: Delayed spinal cord infarction following anterior cervical surgical decompression. BMJ Case Rep. 2017(bcr2017219863)2017.PubMed/NCBI View Article : Google Scholar

12 

Yamazaki M, Koda M, Okawa A and Aiba A: Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum. Spinal Cord. 44:130–134. 2006.PubMed/NCBI View Article : Google Scholar

13 

Taher F, Lebl DR, Cammisa FP, Pinter DW, Sun DY and Girardi FP: Transient neurological deficit following midthoracic decompression for severe stenosis: A series of three cases. Eur Spine J. 22:2057–2061. 2013.PubMed/NCBI View Article : Google Scholar

14 

Yang T, Wu L, Deng X, Yang C, Zhang Y, Zhang D and Xu Y: Delayed neurological deterioration with an unknown cause subsequent to surgery for intraspinal meningiomas. Oncol Lett. 9:2325–2330. 2015.PubMed/NCBI View Article : Google Scholar

15 

Wiginton J IV, Brazdzionis J, Mohrdar C, Sweiss R and Lawandy S: Spinal cord reperfusion injury: Case report, review of the literature, and future treatment strategies. Cureus. 11(e5279)2019.PubMed/NCBI View Article : Google Scholar

16 

Mathkour M, Werner C, Riffle J, Scullen T, Dallapiazza RF, Dumont A and Maulucci C: Reperfusion ‘White Cord’ syndrome in cervical spondylotic myelopathy: Does mean arterial pressure goal make a difference? Additional case and literature review. World Neurosurg. 137:194–199. 2020.PubMed/NCBI View Article : Google Scholar

17 

Antwi P, Grant R, Kuzmik G and Abbed K: ‘White Cord Syndrome’ of acute hemiparesis after posterior cervical decompression and fusion for chronic cervical stenosis. World Neurosurg. 113:33–36. 2018.PubMed/NCBI View Article : Google Scholar

18 

Papaioannou I, Repantis T, Baikousis A and Korovessis P: Late-onset ‘White Cord Syndrome’ in an elderly patient after posterior cervical decompression and fusion: A case report. Spinal Cord Ser Cases. 5(28)2019.PubMed/NCBI View Article : Google Scholar

19 

Jun DS, Baik JM and Lee SK: A case report: White cord syndrome following anterior cervical discectomy and fusion: Importance of prompt diagnosis and treatment. BMC Musculoskelet Disord. 21(157)2020.PubMed/NCBI View Article : Google Scholar

20 

Fehlings MG, Wilson JR, Tetreault LA, Aarabi B, Anderson P, Arnold PM, Brodke DS, Burns AS, Chiba K, Dettori JR, et al: A Clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the Use of methylprednisolone sodium succinate. Global Spine J. 7 (3 Suppl):S203–S211. 2017.PubMed/NCBI View Article : Google Scholar

21 

Vidal PM, Karadimas SK, Ulndreaj A, Laliberte AM, Tetreault L, Forner S, Wang J, Foltz WD and Fehlings MG: Delayed decompression exacerbates ischemia-reperfusion injury in cervical compressive myelopathy. J CI Insight. 2(e92512)2017.PubMed/NCBI View Article : Google Scholar

22 

Vidal PM, Ulndreaj A, Badner A, Hong J and Fehlings MG: Methylprednisolone treatment enhances early recovery following surgical decompression for degenerative cervical myelopathy without compromise to the systemic immune system. J Neuroinflammation. 15(222)2018.PubMed/NCBI View Article : Google Scholar

23 

Sutter M, Eggspuehler A, Jeszenszky D, Kleinstueck F, Fekete TF, Haschtmann D, Porchet F and Dvorak J: The impact and value of uni- and multimodal intraoperative neurophysiological monitoring (IONM) on neurological complications during spine surgery: A prospective study of 2728 patients. Eur Spine J. 28:599–610. 2019.PubMed/NCBI View Article : Google Scholar

24 

Woodroffe RW, Nourski KV, Helland LC, Walsh B, Noeller J, Kerezoudis P and Hitchon PW: Management of iatrogenic spinal cerebrospinal fluid leaks: A cohort of 124 patients. Clin Neurol Neurosurg. 170:61–66. 2018.PubMed/NCBI View Article : Google Scholar

25 

Fang Z, Tian R, Jia YT, Xu TT and Liu Y: Treatment of cerebrospinal fluid leak after spine surgery. Chin J Traumatol. 20:81–83. 2017.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Liao Y, He S and He Z: ‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report. Exp Ther Med 20: 90, 2020.
APA
Liao, Y., He, S., & He, Z. (2020). ‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report. Experimental and Therapeutic Medicine, 20, 90. https://doi.org/10.3892/etm.2020.9218
MLA
Liao, Y., He, S., He, Z."‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report". Experimental and Therapeutic Medicine 20.5 (2020): 90.
Chicago
Liao, Y., He, S., He, Z."‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report". Experimental and Therapeutic Medicine 20, no. 5 (2020): 90. https://doi.org/10.3892/etm.2020.9218
Copy and paste a formatted citation
x
Spandidos Publications style
Liao Y, He S and He Z: ‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report. Exp Ther Med 20: 90, 2020.
APA
Liao, Y., He, S., & He, Z. (2020). ‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report. Experimental and Therapeutic Medicine, 20, 90. https://doi.org/10.3892/etm.2020.9218
MLA
Liao, Y., He, S., He, Z."‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report". Experimental and Therapeutic Medicine 20.5 (2020): 90.
Chicago
Liao, Y., He, S., He, Z."‘White cord syndrome’, a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report". Experimental and Therapeutic Medicine 20, no. 5 (2020): 90. https://doi.org/10.3892/etm.2020.9218
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