Surfer's myelopathy

Overview

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Diagram of the spinal cord

Surfer's myelopathy is a rare, non-traumatic spinal cord injury that occurs predominantly in novice surfers. It is characterized by sudden onset of back pain, followed by neurological deficits such as weakness or paralysis of the lower extremities. The condition is thought to result from hyperextension of the back, leading to ischemia of the spinal cord.

Pathophysiology

The exact mechanism of surfer's myelopathy is not fully understood, but it is believed to involve vascular compromise to the spinal cord. The hyperextension position assumed while paddling on a surfboard may compress the arteries supplying the spinal cord, leading to reduced blood flow and subsequent ischemia. This can result in damage to the neurons and axons within the spinal cord.

Clinical Presentation

Patients with surfer's myelopathy typically present with acute onset of severe back pain, often described as "band-like" across the lower back. This is followed by neurological symptoms such as weakness, numbness, or paralysis in the legs. In some cases, patients may also experience urinary retention or bowel dysfunction.

Diagnosis

The diagnosis of surfer's myelopathy is primarily clinical, supported by imaging studies. Magnetic resonance imaging (MRI) of the spine is the preferred modality, as it can reveal characteristic changes in the spinal cord, such as swelling or signal changes indicative of ischemia.

Treatment

There is no specific treatment for surfer's myelopathy, and management is largely supportive. Initial treatment may include corticosteroids to reduce inflammation and swelling of the spinal cord. Physical therapy and rehabilitation are crucial for recovery, focusing on regaining strength and mobility in the affected limbs.

Prognosis

The prognosis for surfer's myelopathy varies. Some patients experience significant recovery with time and rehabilitation, while others may have persistent neurological deficits. Early diagnosis and intervention are important for improving outcomes.

Prevention

Preventive measures for surfer's myelopathy include educating novice surfers about the risks and encouraging them to take breaks and avoid prolonged hyperextension of the back while paddling. Strengthening core muscles and improving flexibility may also help reduce the risk.

Related pages

• Spinal cord injury
• Ischemia
• Neurology

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