White Cord Syndrome: Myelopathy Caused by an Ossified Posterior Longitudinal Ligament After Posterior Cervical Laminectomy and Fusion

White cord syndrome (WCS) is a rare but serious complication that can occur after spinal decompression surgery. It may be related to reperfusion injury, where blood flow returns to the spinal cord after a period of compression. The patient experienced quadriparesis (weakness in all four limbs) following surgery, and postoperative imaging showed spinal cord edema, which is consistent with WCS. The patient later developed respiratory distress, hemodynamic instability and infection. This case underscores the importance of assessing individual risk factors before surgery, closely monitoring neurological function during surgery, and promptly addressing any signs of WCS if it is suspected.

• 1
  The patient developed WCS after posterior cervical decompression and fusion for cervical stenosis caused by ossification of the posterior longitudinal ligament (OPLL).
• 2
  Intraoperative neuromonitoring signals decreased significantly after laminectomy, indicating potential spinal cord injury.
• 3
  Postoperative MRI revealed spinal cord edema and T2 hyperintensities, consistent with WCS, despite adequate decompression.