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Quadriplegia after lumbar disc surgery. A case report
J J Langmayr1, M Ortler, A Obwegeser
1Neurochirurgische Universitätsklinik, Innsbruck, Austria.
Spine
|August 15, 1996
Summary
A rare case of quadriplegia following lumbar disc surgery in the prone position is reported. Vertebral artery occlusion is suspected, highlighting the need to avoid extreme neck positions during surgery.
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Ischemia in vertebral artery territories after prone back surgery is uncommon.
- Pathogenesis may involve cervical spine degeneration, mechanical vessel obstruction, hypotension, or thromboembolism.
Observation:
- A 33-year-old man developed quadriplegia and occipital lobe dysfunction post-lumbar disc herniation surgery.
- Magnetic resonance imaging revealed cervical spinal cord ischemia.
Findings:
- The patient experienced significant neurological deficits, including quadriplegia.
- Two-year follow-up showed functional recovery, with the patient walking independently with a cane and regaining bladder control.
Implications:
- Temporary mechanical vertebral artery occlusion may cause vertebrobasilar embolism.
- Avoiding extreme head rotation and neck extension in the prone position is crucial during spinal surgery.