Case of postoperative diabetes insipidus following cervical decompressive laminectomies

Postoperative diabetes insipidus (DI) is rare, involving the hypothalamic-pituitary axis following cervical spine surgery.

A 51-year-old male underwent an elective C3-C6 decompressive laminectomy for cervical spinal canal stenosis. Three hours postoperatively, he developed abrupt massive polyuria (1300-1800 mL/h) with polydipsia (specific gravity 1.002), consistent with DI. Treatment with fluid replacement, desmopressin, and vasopressin resulted in clinical improvement. The brain MR revealed a normal pituitary gland and stalk, whereas histology from the laminectomy indicated potential multiple myeloma. At 5-week follow-up, his neurological symptoms resolved, but he continued to require desmopressin for persistent polyuria.

DI is a rare but important complication of a cervical decompressive laminectomy. Early recognition and prompt treatment are essential to prevent significant fluid and electrolyte disturbances.