Brown-Sequard syndrome caused by posterior full-endoscopic cervical discectomy: A case report
Zhen-Yu Zhang1, Tong Zhang1, Longfei Gao2
1Department of Clinical Medicine, Jining Medical University, Jining, Shandong Province, China.
Background:
Posterior full-endoscopic cervical discectomy (PFECD) is an effective and safe technique for cervical radiculopathy. The primary complications of PFECD include temporary nerve root paralysis and dural rupture, while spinal cord damage is exceedingly rare. This study describes a rare case of Brown-Sequard syndrome (BSS) occurring following PFECD and investigates its potential etiologies and pathomechanisms associated with this procedure.
Methods:
Notes and images were reviewed and the relevant literature was analyzed.
Results:
A 50-year-old woman underwent PFECD for cervical radiculopathy. The patient reported substantial alleviation of radicular pain symptoms on the first postoperative day. On the third postoperative day, the patient exhibited acute-onset weakness in the left lower limb, along with diminished pinprick and temperature sensation in the right limb. Cervical spine magnetic resonance imaging demonstrated a newly developed T2 hyperintensity at the C5 spinal cord level. BSS was confirmed based on correlating imaging findings with clinical signs. Following the comprehensive treatment of rehabilitation and pharmacological therapy, the patient's neurological deficits symptoms gradually improvement. At the 6-month follow-up, the patient's symptoms resolved entirely, and the T2 hypersignal diminished markedly on repeat magnetic resonance imaging.
Conclusion:
This study represents the first case of BSS following PFECD. We emphasize that although the PFECD technique is safe and effective, meticulous surgical technique-particularly in foraminal decompression-is critical to avoid iatrogenic spinal cord injury.
