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Suspicious Reperfusion Injury of Spinal Cord After Multilevel Cervical Posterior Decompression without Remarkable Surgical Insult - Two Case Reports -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(2), pp.97-102
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

이규열 1 유성곤 1 김기웅 2

1동아대학교 의과대학 정형외과학교실
2동아대학교

Accredited

ABSTRACT

Study Design: Two case reports. Objectives: We present two cases of quadriplegia after posterior decompression with fusion caused by a suspicious reperfusion injuryof spinal cord without remarkable surgical insult. Summary of Literature Review: Posterior decompression and posterolateral fusion have been reported as effective procedures inpatients with multilevel myelopathy. However, postoperative spinal cord injury without remarkable intraoperative technical damagehas been reported in a few articles. Reperfusion mechanism was suggested as one of the leading causes and reported in some animalmodels. Materials and Methods: There was one case of ossification of the posterior longitudinal ligament and one developmental multilevelstenosis that underwent laminectomy with lateral mass instrumentation. After surgery, the patients presented with quadriplegia; MRIdemonstrated 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 lesionin two cases. Conclusion: Although patients with such a medical condition are rare, it is difficult to predict postoperative swelling of the spinal cordbefore surgery. The surgeon should thus be aware of such rare disease conditions involving the spinal cord before the surgical procedure. Key Words: Cervical myelopathy, Posterior decompression, Reperfusion injury

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