Surfer's myelopathy

Last revised by Daniel J Bell on 10 Nov 2021

Surfer's myelopathy is a rare, non-traumatic spinal cord injury occurring in novice surfers in whom prolonged hyperextension of the back causes infarction of the artery of Adamkiewicz.

These patients are almost always novice surfers 1,2. However, cases of a similar syndrome have been reported with other activities involving back hyperextension, such as gymnastics 3. Thus, some authors have proposed the broader term acute hyperextension myelopathy 3.

Patients present with acute low back pain, followed shortly by bilateral leg numbness and paralysis 1,2

The disorder is a vascular ischemic myelopathy.

Spinal MRI shows a longitudinally extensive, thin, central T2 hyperintense signal abnormality in the spinal cord from the midthoracic region to the conus 4. There is associated diffusion restriction and cord expansion in the acute stage 4,5.

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