Occult respiratory and autonomic dysfunction in craniovertebral anomalies and upper cervical spinal disease

Spine
H L Rosomoff

Abstract

Sudden unexplained death may be seen with treatment of craniovertebral anomalies and surgery of the upper cervical spine. Death is due to sleep-induced apnea, premonitored by periods of confusion, lethargy, and asthenia. There may be associated hypotension, bradycardia, hyponatremia, hypothermia, inappropriate antidiuretic hormone secretion, and difficulty in micturition. The potential for respiratory failure may be predicted if a CO2 response test demonstrates an attenuated or abnormal response. Apnea during sleep may be reversed by arousal or may require ventilatory support for a period of time. The condition is self-limiting, but remains the major life-threatening complication. Both apnea and autonomic dysfunction are treatable and curable with appropriate diagnosis and management.

Citations

May 10, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ali Al KaissiFranz Grill
May 1, 1988·Journal of Neurology, Neurosurgery, and Psychiatry·D R FishL Simon
May 5, 2007·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Carrie L HeikeAnne V Hing
Feb 28, 2002·The Journal of Bone and Joint Surgery. American Volume·James T Guille, Henry H Sherk

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