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http://dx.doi.org/10.5762/KAIS.2019.20.10.303

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review  

Lee, Jeong-Woo (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Lee, Keun Hyeong (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Lee, Ju-Hwan (Department of Anesthesiology and Pain medicine, Wonkwang University College of Medicine)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.20, no.10, 2019 , pp. 303-308 More about this Journal
Abstract
Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.
Keywords
Acute Myelopathy; Anesthesia; Cervical Vertebra; Cervical Disc Herniation; Postoperative;
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