Cord and cauda equina injury complicating elective orthopedic surgery

Spine
Kai-Uwe LewandrowskiDouglas Orr

Abstract

Presented is a case series of 3 patients, all of whom developed neurologic deficits due to cord or cauda equina compression during elective extremity surgery. To identify characteristics of presentation that may differentiate cord or cauda equina injury from peripheral nerve palsy following extremity surgery and to establish the value of early decompression in patients with intraoperative injury. Intraoperative neural injury has been described in association with epidural and spinal anesthesia, with cervical or spinal manipulation in the face of instability, and with ischemic injury suffered during extensive vascular repair. However, it has not been described after uncomplicated elective extremity surgery. Retrospective review of a case series. In 1 patient, intraoperative paraplegia occurred after routine shoulder arthroscopy. A second patient underwent elective bilateral total hip replacement and awoke with neurologic deficits in both lower extremities, then went on to develop an acute cauda equina syndrome. The third patient developed a central cord syndrome following an otherwise uncomplicated total hip replacement. Two patients were initially misdiagnosed as peripheral nerve palsies. All 3 patients had preexisting spinal s...Continue Reading

References

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Citations

Dec 22, 2009·Anesthesia and Analgesia·Terese T Horlocker
Apr 2, 2011·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·Yu-Chieh WangMei-Yung Tsou
May 10, 2007·Acta Anaesthesiologica Scandinavica·M Vercauteren, L Heytens
Aug 12, 2015·Regional Anesthesia and Pain Medicine·Joseph M NealJames P Rathmell
May 15, 2015·Regional Anesthesia and Pain Medicine·Sandra L KoppTerese T Horlocker
Feb 18, 2011·Anesthesiology·Bradley J HindmanKaren B Domino
Oct 11, 2017·BMJ Case Reports·Muhammad Faheem KhanMuhammad Faraz Raghib
Jul 31, 2008·The Journal of the American Academy of Orthopaedic Surgeons·Leo R SpectorDavid Kim

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