Suspicious Reperfusion Injury of Spinal Cord After Multilevel Cervical Posterior Decompression without Remarkable Surgical Insult: Two Case Reports.
10.4184/jkss.2014.21.2.97
- Author:
Kyu Yeol LEE
1
;
Sung Gon YOU
;
Ki Woong KIM
Author Information
1. Department of Orthopedic Surgery, College of Medicine, Dong-A University, Korea. gylee@dau.ac.kr
- Publication Type:Case Report
- Keywords:
Cervical myelopathy;
Posterior decompression;
Reperfusion injury
- MeSH:
Constriction, Pathologic;
Decompression*;
Humans;
Laminectomy;
Longitudinal Ligaments;
Magnetic Resonance Imaging;
Models, Animal;
Quadriplegia;
Rare Diseases;
Reperfusion;
Reperfusion Injury*;
Spinal Cord Diseases;
Spinal Cord Injuries;
Spinal Cord*
- From:Journal of Korean Society of Spine Surgery
2014;21(2):97-102
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: Two case reports. OBJECTIVES: We present two cases of quadriplegia after posterior decompression with fusion caused by a suspicious reperfusion injury of spinal cord without remarkable surgical insult. SUMMARY OF LITERATURE REVIEW: Posterior decompression and posterolateral fusion have been reported as effective procedures in patients with multilevel myelopathy. However, postoperative spinal cord injury without remarkable intraoperative technical damage has been reported in a few articles. Reperfusion mechanism was suggested as one of the leading causes and reported in some animal models. MATERIALS AND METHODS: There was one case of ossification of the posterior longitudinal ligament and one developmental multilevel stenosis that underwent laminectomy with lateral mass instrumentation. After surgery, the patients presented with quadriplegia; MRI demonstrated swelling of the spinal cord and intramedullary lesion in two cases. RESULTS: After surgery, the patients presented with quadriplegia; MRI demonstrated swelling of the spinal cord and intramedullary lesion in two cases. CONCLUSION: Although patients with such a medical condition are rare, it is difficult to predict postoperative swelling of the spinal cord before surgery. The surgeon should thus be aware of such rare disease conditions involving the spinal cord before the surgical procedure.
