# “White Cord Syndrome”: A Reperfusion Injury Following Laminectomy and Spinal Decompression Surgery—A Case Report and Literature Review

## TL;DR

White cord syndrome is a rare spinal surgery complication causing neurological issues, likely due to sudden blood flow restoration to the spinal cord.

## Contribution

This case report adds to the limited literature on white cord syndrome and emphasizes the need for early recognition and treatment.

## Key findings

- A 61-year-old man developed quadriparesis and paresthesia after spinal decompression surgery, consistent with white cord syndrome.
- MRI showed hyperintense T2-weighted signals, and treatment with methylprednisolone led to partial neurological recovery.
- Early diagnosis and aggressive management are crucial for improving outcomes in white cord syndrome.

## Abstract

White cord syndrome (WCS) is a rare but serious postoperative complication characterized by new neurological deficits and hyperintense signal changes on T2‐weighted magnetic resonance imaging (MRI) following spinal decompression surgery. Since it was first described by Chin et al. in 2013, WCS has been attributed to reperfusion injury resulting from sudden restoration of blood flow to chronically ischemic spinal cord tissue. Oxidative stress, microvascular thrombosis, and impaired autoregulation have been proposed as contributing factors. We report the case of a 61‐year‐old Iranian man with a history of cervical canal stenosis who developed quadriparesis and paresthesia following posterior decompression surgery. Postoperative MRI revealed hyperintense signals consistent with WCS. High‐dose methylprednisolone was administered immediately, leading to partial neurological recovery during hospitalization. This case highlights the importance of early recognition and aggressive management of WCS to improve functional outcomes. Raising awareness of this syndrome among spine surgeons is essential for timely diagnosis and management.