Disclosures: Christopher O. James, MD: No financial relationships or conflicts of interest

Case Diagnosis: 32yo male, Acute Paraplegia from Spinal Cord Injury

Case Description or Program Description: 32yo healthy male, while participating in a beginner’s surfing course, started experiencing a heavy sensation within his legs and sharp lower back pain thirty minutes after concluding his lesson. His symptoms continued to progress over the course of the afternoon with subsequent hyperesthesia from the waist down, inability to ambulate, and urinary incontinence, prompting his admission to an acute care facility. Initial work-up from acute care aligned with the suspected diagnosis of Surfer’s Myelopathy, as the thoracic and lumbar MRI-spine demonstrated intramedullary T2 hyperintensities from T8-T9 to the conus medullaris tip at L1. Meningitis/encephalitis panel, CSF PCR analysis, and other diagnostic markers were unremarkable. A five-day course of IV Methylprednisolone 1,000mg was administered and he started to appreciate minimal recovery of his proximal hip muscles, along with decreased hyperesthesia. He was later transferred to our acute rehab facility where he completed one month of inpatient rehabilitation. International Standard Examination was performed on admission, eleven days from his injury: classifying him as an L1 AIS B. Patient was fully committed to his inpatient rehabilitation and made moderate improvements with lower extremity strength; furthermore, was able to regain functional independence prior to his to discharge home.

Setting: Acute Rehabilitation Hospital

Assessment/Results: Patient was able to establish independence with mobility at the wheelchair level and with transfers, implement appropriate bowel and bladder management, and incorporate pressure relief in his daily routine. He was employed prior to his injury and was able to learn work-related adaptations during this rehabilitation; hence allowing him to resume his career.

Discussion (relevance): Despite the uncertainty of neurologic recovery in Surfer’s Myelopathy, it is salient to provide patients with tools for maximal independence while stressing patience in the recovery process.

Conclusions: Acute Rehabilitation is paramount when addressing deficits from Surfer’s Myelopathy.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/rehabilitation-in-acute-surfers-myelopathy-a-case-study/