Reversal of neurologic deterioration after vertebral column resection by spinal cord untethering and duraplasty

Spine
Brian A O'ShaughnessyStephen L Ondra

Abstract

Case report. To describe a novel surgical approach for the treatment of a patient who developed neurologic deterioration after vertebral column resection (VCR). VCR is a valuable osteotomy technique for the treatment of fixed spinal deformity. Despite an evolving compendium of information about this procedure, little has been described regarding the management of neurologic complications after VCR. A 58-year-old woman underwent a T12 VCR for the treatment of fixed sagittal post-traumatic deformity. The patient was monitored intraoperatively with SSEPs and TcMEPs, both of which revealed no changes at any point during the operation. She awoke with normal motor function; however, her strength and sensory modalities deteriorated in a gradual progressive pattern over the first several postoperative days. She was then taken back to the operating room and intradural exploration was performed at the osteotomy site. The patient was found to have dense arachnoid adhesions that tethered the spinal cord to the dura at the level of the osteotomy. With spinal column shortening during osteotomy closure, tension was placed on the spinal cord, which was bound by the adhesions. Spinal cord untethering and duraplasty proved to be successful in re...Continue Reading

Citations

May 16, 2009·Journal of Neurosurgery. Spine·Michael G Fehlings, Babak Arvin
Apr 19, 2011·Journal of Neurosurgery. Spine·Vincent C Traynelis
Jul 3, 2010·Neurosurgical Focus·Patrick ShihTyler R Koski
Apr 19, 2011·Journal of Neurosurgery. Spine·Shoichi KokubunYasuhisa Tanaka
Aug 14, 2010·Orthopedics·Patrick F BerginKhaled M Kebaish
Jul 5, 2011·Journal of Biomechanics·Hiroshi OzawaEiji Itoi
Nov 28, 2014·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·Vincent Arlet
Dec 15, 2015·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·Shengru WangXisheng Weng

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