Gradual neurologic deterioration post kyphoscoliosis correction surgery: a case report

A 13-year-9-month-old female child presented with congenital kyphoscoliosis along with progressive paraparesis. Radiographs confirmed kyphoscoliosis and magnetic resonance imaging revealed a stretched and flattened spinal cord over the kyphotic deformity and a T7 hemivertebra. She underwent a posterior correction of the curve along with posterior decompression and a posterior to anterior excision of T7 hemivertebra to relieve her of the deteriorating neurology. While carrying out the excision of T7 hemivertebra, her trans cranial electrical motor evoke potential dropped. Consequently, she was administered a mega dose steroid therapy. After a positive wake-up test, the excision was discontinued and surgery was concluded by in situ fixation of the deformity with short rods. Thereafter, a gradual deterioration in the neurologic status was observed and patient became paraplegic on the fourth post operative day. In this case report, we try to analyze various causes for gradual deterioration in neurologic status.