Young Man With Paraparesis

A 24-year-old man presented to our emergency department with paraparesis and urinary retention. The previous day, he had participated in his first beginner surfing lesson. Near the end of the 2-hour lesson, he experienced the acute onset of severe lower back pain when arching his back while attempting to stand to catch a wave. He had the strength to swim to shore, but within an hour he developed progressive bilateral lower-extremity numbness and weakness, and urinary retention. Physical examination was notable for bilateral lower-extremity weakness and hyperesthesia.

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