1207 - A look into the outpatient management and rehabilitation progress of a patient with surfer’s myelopathy

Case Diagnosis: Surfer’s myelopathy is a rare, non-traumatic spinal cord injury seen amongst inexperienced surfers, the etiology of which being suspected to be ischemia due to compression of the artery of Adamkiewicz secondary to hyperextension of the back. In 2016, only 64 cases had been reported.

Case Description: An 18-year-old gentleman presented to clinic for physiatric management of his spinal cord injury. The patient reported surfing in early 2022 for the first time when he stood up quickly on his board after lying prone; he noted some brief pain but continued to surf. He then began to feel weakness in his legs and swam to shore, where he noted he was unable stand up and eventually lost sensation in his legs. He was taken to a hospital where he was diagnosed with a T11 American Spinal Injury Association (ASIA) class A injury and later underwent inpatient acute rehabilitation. He presented to the physiatry clinic about 1 month after discharge, and the level of injury was confirmed with a repeat ASIA exam.

Discussions: Since being at the clinic (about 1.5 years), hip flexion, abduction, and adduction strength have improved per Medical Research Counsel, and a repeat expedited ASIA exam revealed that the patient’s neurological level of injury (NLI) has improved to T12. This case report serves to add qualitative data to the literature regarding this phenomenon, especially since it uniquely contains observations of the outpatient management and rehabilitation progress of a patient with this rare injury.

Conclusions: Examination of this case could reveal insight concerning the prognosis of this type of injury as well as potential factors for optimizing rehabilitation outcomes.