A Rare Case of Bilateral Foot Drop Following Cervical Decompression in Tandem Spinal Stenosis

This case report describes a 70-year-old male presenting with limb weakness, urinary retention and tandem cervical and lumbar spinal stenosis with complicating white cord syndrome, a rare reperfusion injury post decompression surgery. Initially admitted following an unwitnessed fall, the patient's neurological examination indicated that progressive weakness of the limbs and sensory loss etiology is cervical and lumbar spondylosis with severe spinal canal stenosis, confirmed by imaging. Due to rapid deterioration, he underwent C5 corpectomy, cervical decompression and fusion. Informed consent for surgery was obtained from the patient. Post-surgery, he experienced transient improvements but soon developed delirium, worsening right-sided weakness, and bilateral foot drop. Diagnosis of white cord syndrome was made because of repeat cervical MRI findings having signal changes in cervical spine. Subsequent treatment included intravenous steroids, antibiotics, and eventual lumbar interbody fusion. The multifactorial nature of his postoperative complications including hyperactive delirium and urinary tract infection, underscores the complexities associated with tandem stenosis and white cord syndrome management. The case highlights the need for early intervention in tandem spinal stenosis cases, cautious intraoperative monitoring, and risk factors management for reperfusion injury, stressing the role of comprehensive postoperative care to improve functional outcomes.