ABSTRACT
Three patients with diagnoses of surfer's myelopathy (24-31 yrs old; two men, one woman) were admitted to our rehabilitation hospital. All three patients were novice surfers and had a typical clinical course of onset: rapid progression of paraplegia after back pain while taking surfing lessons. Despite months of rehabilitation at our hospital, in all three patients, complete paraplegia (T9-T12) and bladder-bowel dysfunction remained. Our case profiles suggest that the neurologic outcome of surfer's myelopathy is potentially catastrophic, as has been suggested in previous reports. Surfer's myelopathy has been estimated to be an ischemic thoracic myelopathy. From our case profiles and review of the literature, not only the prolonged prone hyperextended posture of paddling but also the repetitive mechanical stress caused by flexion-extension of the spinal column may be related to its pathogenesis. To prevent surfer's myelopathy and to avoid progressive deterioration of neurologic function, increased education and awareness are essential.
Subject(s)
Paraplegia/rehabilitation , Spinal Cord Ischemia/rehabilitation , Swimming/injuries , Adult , Female , Humans , Injury Severity Score , Long-Term Care , Magnetic Resonance Imaging , Male , Paraplegia/diagnosis , Paraplegia/etiology , Physical Therapy Modalities , Prognosis , Risk Assessment , Sampling Studies , Spinal Cord Ischemia/complications , Spinal Cord Ischemia/diagnosis , Time Factors , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: To compare outcomes, complications, and therapy intensity of inpatient rehabilitation in patients with paraplegia caused by spinal cord injury associated with aortic aneurysm repair (SCI-AA) versus patients with traumatic spinal cord injury (SCI). DESIGN: Case-controlled study. SETTING: SCI unit in a rehabilitation center. PARTICIPANTS: Seventeen patients with SCI-AA and 17 patients with traumatic SCI. INTERVENTION: Standard rehabilitation therapy for SCI. MAIN OUTCOME MEASURES: Length of stay (LOS) in acute and rehabilitation hospitals; FIM instrument scores; FIM change; FIM efficiency; complications; therapy intensity; and ambulatory state and return to community at discharge. RESULTS: No significant differences were noted in acute and rehabilitation LOS and admission FIM scores. Discharge FIM scores, FIM change, and FIM efficiencies were significantly lower in the SCI-AA group, which had many complications related to AA and SCI. Intensity of rehabilitation sports therapy in the SCI-AA group was significantly lower than that of the traumatic SCI group, but total therapy intensity did not differ significantly. Both had similar rates of return to ambulatory state and discharge to the community. CONCLUSIONS: SCI-AA patients had many complications that interfered with rehabilitation therapy, and could not achieve functional gains comparable to those with traumatic SCI. However, both groups achieved comparable success with return to ambulatory state and discharge to the community.