Stevens Quails E, Dickerman Rob D, Kattner Keith A, Stroink Ann R
Bromenn Regional Medical Center, Department of Surgery, Section of Neurosurgery, Normal, Illinois, USA.
J Spinal Cord Med. 2006;29(4):425-9. doi: 10.1080/10790268.2006.11753892.
Single case report and extensive literature review.
To present the first such report of cervical cord contusion after the percutaneous placement of gold-seed fiducials. The pathomechanics and surgical recommendations are reviewed.
Spinal cord injuries are well documented in the medical literature. These injuries range from cord contusion to transection and result primarily from trauma. A single case report of a patient who was found to have a nonhemorrhagic cervical spinal cord contusion after percutaneous fiducial implantation is presented.
Single case report.
The patient underwent percutaneous placement of fiducials for stereotactic radiosurgery for a nerve sheath tumor. Postoperatively she had primarily sensory complaints; no motor deficits were detected on neurological examination. Neuroimaging studies demonstrated nonhemorrhagic cervical cord contusion. She was treated conservatively and had complete resolution of her symptoms.
The likely mechanism for the contusion was neck hyperextension during thrusting maneuvers during fiducial implantation. This is yet another report of normal intraoperative-evoked potentials with postoperative neurological sequelae. A dedicated team approach involving ancillary staff, anesthesiologists, and surgeons should be utilized to avert this potentially devastating complication.
单病例报告及广泛的文献综述。
呈现经皮植入金种子标记物后发生颈髓挫伤的首例此类报告。对其发病机制及手术建议进行综述。
脊髓损伤在医学文献中有充分记载。这些损伤范围从脊髓挫伤至横断，主要由外伤导致。本文呈现了一例患者在经皮植入标记物后被发现有非出血性颈髓挫伤的单病例报告。
单病例报告。
该患者因神经鞘瘤接受了用于立体定向放射外科的标记物经皮植入。术后她主要有感觉方面的不适；神经检查未发现运动功能缺损。神经影像学研究显示为非出血性颈髓挫伤。她接受了保守治疗，症状完全缓解。
挫伤的可能机制是在植入标记物时推注操作过程中颈部过度伸展。这是另一例术中诱发电位正常但术后出现神经后遗症的报告。应采用由辅助人员、麻醉师和外科医生组成的专业团队方法来避免这种潜在的灾难性并发症。
