We read with great interest the article by Drs Zhang and Wang reviewing subacute posttraumatic ascending myelopathy (SPAM).1 We recently reported a case of SPAM2 that was not included in their paper, likely due to timing of publication. We also conducted a literature review, which drew many of the same conclusions as Drs Zhang and Wang’s paper.

Drs Zhang and Wang’s review contains images, though no detailed description, of a case they previously reported.3 This case is interesting especially in that the patient described presumably died as a result of respiratory depression from SPAM affecting the cervical spinal cord. We are not aware of another case of mortality directly attributed to SPAM.

SPAM is a rare and potentially catastrophic complication of spinal cord injury (SCI). Though more common after complete SCI, our patient developed SPAM after a mild SCI. Drs Zhang and Wang’s paper further emphasizes the need for physicians to be vigilant for this entity as there are likely many unreported cases.