In Reply: Surfer's Myelopathy: A Rare Form of Spinal Cord Infarction in Novice Surfers: A Systematic Review

ABBREVIATIONS FCE fibrocartilaginous embolization To the Editor: We would like to thank Dr. Reisner and his colleagues in Atlanta, GA for highlighting another rare, but devastating cause of acute spinal cord injury in the young and healthy following no trauma or innocuous trauma.1 Fibrocartilaginous embolization (FCE) is indeed a well-documented etiology for such injuries. While, there was no stigmata of FCE in the case we reported, it is possible that this may coexist in other cases of Surfer's myelopathy. Dr. Reisner's unpublished observation that magnetic resonance imaging scans in patients who are diagnosed with FCE-related acute spinal cord injury tend to show an annular fissure, which on follow-up imaging tends to enhance with contrast is a unique finding and represents a potential premortem, noninvasive method for confirming this diagnosis. We are unaware of similar observations. We would encourage this group to publicize these data. While correlation of this finding to confirmed FCE events may not change outcome for these patients, it may enable earlier definitive understanding of the event, when it occurs. We greatly appreciate the author's kind words regarding our work2 and hope that it has similar impact on others. Since the primary means of reducing the impact of surfer's myelopathy is prevention, we are actively seeking methods to publicize this risk in lay literature. Disclosure The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.