Surfer's myelopathy: Difference between revisions

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{{short description|A spinal cord injury caused by hyperextension of the back}}
{{DISPLAYTITLE:Surfer's Myelopathy}}
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| image          = Blausen 0822 SpinalCord.png
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| caption        = Spinal cord
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| specialty      = neurology
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'''Surfer's myelopathy''' is a rare nontraumatic injury causing [[paraplegia]] which is paralysis below the waist.<ref>{{cite book|last1=Hawkes|first1=Christopher H.|last2=Sethi|first2=Kapil D.|last3=Swift|first3=Thomas R.|title=Instant Neurological Diagnosis: A Companion to Neurobowl|publisher=Oxford University Press|page=286|isbn=9780190206284|url=https://books.google.com/?id=dNkmDAAAQBAJ&pg=PA286&dq=Surfer's+myelopathy#v=onepage&q=Surfer's%20myelopathy&f=false|accessdate=25 September 2016|language=en|date=2016-03-29}}</ref> It is a [[spinal cord]] [[injury]] caused by [[extension (kinesiology)#Hyperextension|hyperextension]] of the back. When the back is hyperextended, a [[blood vessel]] leading to the spine can become kinked, depriving the spinal cord of [[oxygen]]<ref>{{cite book|last1=Harrigan|first1=Mark R.|last2=Deveikis|first2=John P.|title=Handbook of cerebrovascular disease and neurointerventional technique|date=2012|publisher=Springer|location=New York|isbn=9781617799457|page=816|edition=2nd|url=https://books.google.com/?id=aUh1JA82zCMC&pg=PA816&dq=surfers+myelopathy+spinal+cord+injury+caused+by+hyperextension+of+the+back.#v=onepage&q=surfers%20myelopathy%20spinal%20cord%20injury%20caused%20by%20hyperextension%20of%20the%20back.&f=false|accessdate=25 September 2016|language=en}}</ref> The condition gets its name because the phenomenon is most often seen in those [[surfing]] for the first time, but it can be caused by any activity in which the back is hyperextended ([[yoga]], [[pilates]], etc.). In some cases the paralysis is permanent.<ref name="magicseaweed">{{Cite web|url=https://magicseaweed.com/news/beginner-surfer-left-paralysed-after-suffering-rare-surfers-myelopathy/9263/|title=Beginner Surfer Left Paralysed after Suffering Rare Surfer's Myelopathy|last=Rode|first=Matt|date=2016-07-25|website=magicseaweed.com|language=en|archive-url=https://web.archive.org/web/20190428085735/https://magicseaweed.com/news/beginner-surfer-left-paralysed-after-suffering-rare-surfers-myelopathy/9263/|archive-date=2019-04-28|dead-url=no|access-date=2019-07-24}}</ref>


== Prevention ==
== Overview ==
According to [[Doctor of Physical Therapy|DPT]] Sergio Florian, some recommendations for preventing myelopathy is proper warm up, limiting the session length and sitting on the board while waiting for waves, rather than lying.<ref name="magicseaweed" />
[[File:Blausen_0822_SpinalCord.png|thumb|right|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.


<gallery>
== Pathophysiology ==
Surf IMG 9494-1 (3119176702).jpg|A surfer paddling.
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.
Surf IMG 0599-1 (3119243190).jpg|A surfer paddling.
Surfer sitting on his board.jpg|Surfer sitting on his board, thereby resting his back.
</gallery>
== History ==
A case series of 19 novice surfers with nontraumatic myelopathy was published in 2012, with all patients' MRI scans showing hyperintensity from the lower thoracic spinal cord to the conus medullaris.<ref name="pmid23152585">{{cite journal |vauthors = Chang CW, Donovan DJ, Liem LK, O'Phelan KH, Green DM, Bassin S, Asai S |title = Surfers' myelopathy: a case series of 19 novice surfers with nontraumatic myelopathy |journal = Neurology |volume = 79 |issue = 22 |pages = 2171–6 |year = 2012 |pmid = 23152585 |doi = 10.1212/WNL.0b013e31827595cd }}</ref> An additional study of 23 cases was published in 2013.<ref>{{Cite journal|last=Nakamoto|first=B. K.|last2=Siu|first2=A. M.|last3=Hashiba|first3=K. A.|last4=Sinclair|first4=B. T.|last5=Baker|first5=B. J.|last6=Gerber|first6=M. S.|last7=McMurtray|first7=A. M.|last8=Pearce|first8=A. M.|last9=Pearce|first9=J. W.|date=2013-12-01|title=Surfer's Myelopathy: A Radiologic Study of 23 Cases|journal=American Journal of Neuroradiology|language=en|volume=34|issue=12|pages=2393–2398|doi=10.3174/ajnr.A3599|issn=0195-6108|pmc=4326257|pmid=23828111}}</ref>


==See also==
== Clinical Presentation ==
*{{annotated link|Rehabilitation in spinal cord injury}}
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.


==References ==
== Diagnosis ==
{{reflist}}
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.


==Further reading==
== Treatment ==
*{{cite book|last1=Acton|first1=Ashton|title=Spinal Cord Vascular Diseases—Advances in Research and Treatment: 2012 Edition: ScholarlyPaper|publisher=ScholarlyEditions|isbn=9781481645065|url=https://books.google.com/?id=mm9AerdVCskC&pg=PP10&dq=surfers+myelopathy+spinal+cord+injury+caused+by+hyperextension+of+the+back.#v=onepage&q=surfers%20myelopathy%20spinal%20cord%20injury%20caused%20by%20hyperextension%20of%20the%20back.&f=false|accessdate=25 September 2016|language=en|date=2012-12-26}}
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.


{{Surfing}}
== Prevention ==
{{Medicine}}
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.
 
[[Category:Neurological disorders]]
[[Category:Rare diseases]]
[[Category:Surfing]]


== Related pages ==
* [[Spinal cord injury]]
* [[Ischemia]]
* [[Neurology]]


{{circulatory-disease-stub}}
[[Category:Neurology]]
{{surfing-stub}}
[[Category:Spinal cord disorders]]
{{dictionary-stub1}}

Revision as of 06:16, 16 February 2025


Overview

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