Background: Decompression sickness may involve the central nervous system, and the most common
site is spinal cord. This study was conducted to determine the relationship between magnetic
resonance (MR) imaging findings of spinal damage and clinical findings in acute decompression
sickness.

Methods: We conducted a retrospective review of 12 patients (male=10, female=2) who presented with
spinal cord symptoms. We investigated their clinical features, neurological findings and radiologic
findings.

Results: The depth and bottom time of the dive were 34.5 meters (range 22-56) and 22.7 minutes
(range 10-55) respectively. Most divers ascended within appropriate time frame as shown by the
decompression tables. The most frequent initial symptoms were lower limbs weakness (n=12),
followed by sensory disturbances (n=10) and bladder dysfunction (n=5). The chief radiologic
abnormalities were continuous (n=3), or non-continuous (n=5) high signal intensity on T2-weighted
images at posterior paramedian portion of the spinal cord, mainly thoracic level. There were no
abnormal findings in remaining 4 patients and they showed good prognosis. All patients were treated
with hyperbaric oxygen therapy and some received high dose dexamethasone. On discharge, 5
patients had made a full recovery, 7 had some residual neurological sequelae, and most patients
except one regained normal bladder function.

Conclusions: Spinal cord decompression sickness is a neurological emergency. Early recognition and
treatment may minimize neurological damage. Initial normal finding in MR imaging was a good
predictor for prognosis in spinal decompression sickness.

KEYWORDS : Decompression sickness,Spinal cord, Hyperbaric oxygen therapy