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Spinal segmental myoclonus following spinal surgery.
Shrikant Pande1, Kokcher Ang1, May Win Myat1
1Department of Rehabilitation Medicine, Changi General Hospital, Singapore, Singapore.
British Journal of Neurosurgery
|June 13, 2020
Summary
A patient with spondylodiscitis and an epidural abscess developed spinal segmental myoclonus post-surgery. Treatment with clonazepam successfully managed the myoclonus, aiding rehabilitation.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Disease
Background:
- A 44-year-old male presented with L5/S1 spondylodiscitis and a posterior epidural abscess causing severe spinal canal stenosis and cauda equina compression.
- The patient underwent computed tomography (CT)-guided drainage and L5/S1 decompression laminectomy, followed by a 6-week course of intravenous antibiotics.
Observation:
- Despite initial recovery and improving inflammatory markers, the patient developed intermittent right lower limb myoclonic movements.
- Severe back pain radiating to the gluteal region accompanied the myoclonus, significantly hindering rehabilitation progress.
Findings:
- The clinical presentation and history of recent spinal surgery led to a diagnosis of spinal segmental myoclonus.
- The patient's condition was successfully managed with a course of clonazepam.
Implications:
- This case highlights spinal segmental myoclonus as a potential complication following spinal surgery for infection.
- Effective pharmacological management with clonazepam can facilitate functional recovery and rehabilitation in such cases.
- Early recognition and targeted treatment are crucial for improving patient outcomes after complex spinal procedures.
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