Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation
Study design: Retrospective Case Review. Objectives: To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury. Setting: National Spinal Injuries Centre, S...
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| Veröffentlicht in: | Spinal cord 2008-02, Vol.46 (2), p.140-144 |
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| creator | Planner, A C Pretorius, P M Graham, A Meagher, T M |
| description | Study design:
Retrospective Case Review.
Objectives:
To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury.
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.
Materials and methods:
A retrospective review of the case notes and MRI studies of 11 cases with typical MRI features of ascending myelopathy presenting to a tertiary Spinal Injuries centre over a 15-year period.
Results:
Eleven patients were identified with MRI features typical of SPAM, a median of 13 days (mean 24, range 4–86 days) following cord injury. The median number of cord segments involved above the initial insult was 6 (mean 6.2, range 4–11). MRI appearances include extension four or more segments cephalad to the initial cord injured segment, cord expansion and increased intramedullary T2 signal with a rim of cord sparing peripherally. Cord changes and neurological deficits improved over time but did not return to the initial injured level on MRI. One patient died (mortality 9%).
Conclusion:
SPAM is a rare cause of neurological deterioration following spinal cord injury but may remain subclinical. SPAM most commonly presents as neurological deterioration but may present with shoulder pain, respiratory deterioration or remain subclinical. There are characteristic MRI appearances. It can be fatal. |
| doi_str_mv | 10.1038/sj.sc.3102056 |
| format | Article |
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Retrospective Case Review.
Objectives:
To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury.
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.
Materials and methods:
A retrospective review of the case notes and MRI studies of 11 cases with typical MRI features of ascending myelopathy presenting to a tertiary Spinal Injuries centre over a 15-year period.
Results:
Eleven patients were identified with MRI features typical of SPAM, a median of 13 days (mean 24, range 4–86 days) following cord injury. The median number of cord segments involved above the initial insult was 6 (mean 6.2, range 4–11). MRI appearances include extension four or more segments cephalad to the initial cord injured segment, cord expansion and increased intramedullary T2 signal with a rim of cord sparing peripherally. Cord changes and neurological deficits improved over time but did not return to the initial injured level on MRI. One patient died (mortality 9%).
Conclusion:
SPAM is a rare cause of neurological deterioration following spinal cord injury but may remain subclinical. SPAM most commonly presents as neurological deterioration but may present with shoulder pain, respiratory deterioration or remain subclinical. There are characteristic MRI appearances. It can be fatal.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sj.sc.3102056</identifier><identifier>PMID: 17406377</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adolescent ; Adult ; Anatomy ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cerebrospinal fluid. Meninges. Spinal cord ; Female ; Human Physiology ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurochemistry ; Neurology ; Neuropsychology ; Neurosciences ; original-article ; Retrospective Studies ; Spinal Cord Diseases - etiology ; Spinal Cord Diseases - pathology ; Spinal Cord Diseases - physiopathology ; Spinal Cord Injuries - complications ; Traumas. Diseases due to physical agents</subject><ispartof>Spinal cord, 2008-02, Vol.46 (2), p.140-144</ispartof><rights>Springer Nature Limited 2008</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Feb 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-c64f2017b068e7b3620ed4368ccaca60de5ecad02b472b85de42582557245a293</citedby><cites>FETCH-LOGICAL-c524t-c64f2017b068e7b3620ed4368ccaca60de5ecad02b472b85de42582557245a293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sj.sc.3102056$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sj.sc.3102056$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20057628$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17406377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Planner, A C</creatorcontrib><creatorcontrib>Pretorius, P M</creatorcontrib><creatorcontrib>Graham, A</creatorcontrib><creatorcontrib>Meagher, T M</creatorcontrib><title>Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Retrospective Case Review.
Objectives:
To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury.
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.
Materials and methods:
A retrospective review of the case notes and MRI studies of 11 cases with typical MRI features of ascending myelopathy presenting to a tertiary Spinal Injuries centre over a 15-year period.
Results:
Eleven patients were identified with MRI features typical of SPAM, a median of 13 days (mean 24, range 4–86 days) following cord injury. The median number of cord segments involved above the initial insult was 6 (mean 6.2, range 4–11). MRI appearances include extension four or more segments cephalad to the initial cord injured segment, cord expansion and increased intramedullary T2 signal with a rim of cord sparing peripherally. Cord changes and neurological deficits improved over time but did not return to the initial injured level on MRI. One patient died (mortality 9%).
Conclusion:
SPAM is a rare cause of neurological deterioration following spinal cord injury but may remain subclinical. SPAM most commonly presents as neurological deterioration but may present with shoulder pain, respiratory deterioration or remain subclinical. There are characteristic MRI appearances. It can be fatal.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anatomy</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Female</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurochemistry</subject><subject>Neurology</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>original-article</subject><subject>Retrospective Studies</subject><subject>Spinal Cord Diseases - etiology</subject><subject>Spinal Cord Diseases - pathology</subject><subject>Spinal Cord Diseases - physiopathology</subject><subject>Spinal Cord Injuries - complications</subject><subject>Traumas. 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Meninges. Spinal cord</topic><topic>Female</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurochemistry</topic><topic>Neurology</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>original-article</topic><topic>Retrospective Studies</topic><topic>Spinal Cord Diseases - etiology</topic><topic>Spinal Cord Diseases - pathology</topic><topic>Spinal Cord Diseases - physiopathology</topic><topic>Spinal Cord Injuries - complications</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Planner, A C</creatorcontrib><creatorcontrib>Pretorius, P M</creatorcontrib><creatorcontrib>Graham, A</creatorcontrib><creatorcontrib>Meagher, T M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Planner, A C</au><au>Pretorius, P M</au><au>Graham, A</au><au>Meagher, T M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>46</volume><issue>2</issue><spage>140</spage><epage>144</epage><pages>140-144</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Retrospective Case Review.
Objectives:
To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury.
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.
Materials and methods:
A retrospective review of the case notes and MRI studies of 11 cases with typical MRI features of ascending myelopathy presenting to a tertiary Spinal Injuries centre over a 15-year period.
Results:
Eleven patients were identified with MRI features typical of SPAM, a median of 13 days (mean 24, range 4–86 days) following cord injury. The median number of cord segments involved above the initial insult was 6 (mean 6.2, range 4–11). MRI appearances include extension four or more segments cephalad to the initial cord injured segment, cord expansion and increased intramedullary T2 signal with a rim of cord sparing peripherally. Cord changes and neurological deficits improved over time but did not return to the initial injured level on MRI. One patient died (mortality 9%).
Conclusion:
SPAM is a rare cause of neurological deterioration following spinal cord injury but may remain subclinical. SPAM most commonly presents as neurological deterioration but may present with shoulder pain, respiratory deterioration or remain subclinical. There are characteristic MRI appearances. It can be fatal.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>17406377</pmid><doi>10.1038/sj.sc.3102056</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Spinal cord, 2008-02, Vol.46 (2), p.140-144 |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Anatomy Biological and medical sciences Biomedical and Life Sciences Biomedicine Cerebrospinal fluid. Meninges. Spinal cord Female Human Physiology Humans Injuries of the nervous system and the skull. Diseases due to physical agents Magnetic Resonance Imaging Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurochemistry Neurology Neuropsychology Neurosciences original-article Retrospective Studies Spinal Cord Diseases - etiology Spinal Cord Diseases - pathology Spinal Cord Diseases - physiopathology Spinal Cord Injuries - complications Traumas. Diseases due to physical agents |
| title | Subacute progressive ascending myelopathy following spinal cord injury: MRI appearances and clinical presentation |
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