Spinal cord decompression sickness in sport diving.
OBJECTIVE
To summarize 16 years' experience in the diagnosis and treatment of spinal cord decompression sickness in Israel.


METHODS
The survey data were collected firsthand by physicians trained in underwater diving medicine.


METHODS
The Israeli Naval Medical Institute, Israel's national hyperbaric referral center.


METHODS
Sixty-eight sport divers diagnosed as having spinal cord decompression sickness.


METHODS
Hydration and 100% oxygen breathing until the patient reached the hyperbaric chamber. All patients received recompression therapy on US Navy treatment tables using oxygen, except for six who were treated by Comex Treatment Table CX-30, which uses helium in addition to oxygen.


METHODS
Neurological examination after the completion of recompression therapy.


RESULTS
Forty-one percent of the dives were performed within the decompression limits of the US Navy standard decompression tables. Risk factors were fatigue, circumstances suggesting dehydration, and extreme physical effort. The most common presenting symptoms were paresthesias, weakness of the legs, lower back pain, or abdominal pain. Full recovery was achieved in 79% of the patients. Spinal symptoms appeared immediately on surfacing in six of the eight patients who continued to have multiple neurological sequelae.


CONCLUSIONS
United States Navy air decompression tables appear not to be completely safe for sport divers. Even mild spinal symptoms identified on surfacing should be treated vigorously. High-pressure oxygen-helium therapy seems to be a promising alternative in cases of severe spinal cord decompression sickness.
Aharon-Peretz
J
J
Department of Neurology, Rambam Medical Center, Haifa, Israel.
Adir
Y
Y
Gordon
C R
CR
Kol
S
S
Gal
N
N
Melamed
Y
Y
D000328:Adult; D000368:Aged; D001775:Blood Circulation; D003665:Decompression Sickness / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D004242:Diving; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy
D010100:Oxygen