Abstract
We present a case of spinal cord infarction with acute spinal cord oedema treated by laminoplasty. A 44-year-old man presented with numbness in the left arm. The patient reported neck pain, which had begun the previous day followed by numbness in the upper left arm on the day of presentation. The sensory disturbance was precipitate and muscle weakness in the left lower limb was noted. The results of laboratory tests, including CBC, chemistry, coagulation, bleeding time, and CSF test, were within normal limits at the time of presentation. Physical examination showed weakness of the triceps brachii and brachioradial muscles, sensory disturbance in the left hand, and bladder dysfunction. T2 weighted MRI in the horizontal plane showed oedematous tissues in the cervical spinal cord with intermingled regions of high and low signal intensity. The patient was hospitalized immediately with a diagnosis of spinal cord infarction.
Solu-medrol® (methylprednisolone) was started to stabilize swollen tissues. However, because of severe pain that could not be managed even with morphine, deterioration of muscle paralysis, and sensory disturbance, the patient underwent laminoplasty for C3 to C7 using the Hirabayashi method on day 1 of hospitalization. The patient was followed up postoperatively and after discharge. The patient has been well. He returned to work a year after treatment with minimal residual numbness in the left arm, and has mostly recovered his muscle strength. This operation resulted in almost complete amelioration of muscle paralysis one year later. This observation indicated that decompression by laminoplasty is an invaluable treatment for spinal cord infarction.
