Article

A retrospective series of cases. OBJECTIVE: To identify, among
post-traumatic myelopathies, a specific entity in which clinical and radiological
features are not extensive but are strictly limited to the perilesional zone.
SETTING: The data set of the Regional Spinal Cord Injury Department of Nantes,
France. METHODS: A systematic analysis of all traumatic spinal cord injury (SCI)
patients who presented with a neurological aggravation delayed from initial
injury, without syringomyelia or extensive myelomalacia. RESULTS: Twelve patients
presenting with this type of complication were identified (that is, four
tetraplegics and eight paraplegics). The neurological worsening consisted in
weakness of the muscles close to the motor level in five patients, and in
isolated at-level neuropathic pain in seven patients. A tethered cord was
evidenced by the magnetic resonance imaging (MRI) results in all of the patients.
Roots were involved by the tethering on the MRI results in eight cases. Surgery,
with untethering and expansile duraplasty, was performed in all cases. Surgery
allowed motor recovery in patients who presented with a motor loss (motor score
gain range=1-7 points; median=3) and decreased pain in all pain patients
(decrease on the 10-point numerical rating scale: range=1-6 points; median=4).
CONCLUSIONS: In traumatic SCI patients, a tethered cord could be responsible for
clinical and radiological changes, which are strictly localised to the
perilesional area. The term perilesional myeloradiculopathy is proposed for this
complication, which requires cord release surgery.

Langue : ANGLAIS