Bragança João, Hanauer Matthieu, Racloz Guillaume
Department of Orthopaedics and Traumatology, Réseau Hospitalier Neuchâtelois, Rue de la Maladière 45, 2000 Neuchâtel, Switzerland.
Case Rep Orthop. 2020 Sep 16;2020:3086787. doi: 10.1155/2020/3086787. eCollection 2020.
Peripheral nerve injury is a well-known surgical complication related to the position of the patient. Moreover, in spine surgery, prone position for prolonged period places the patient at increased risk. The aim of this study was to report a case of a radial nerve neuropraxis due to compression by C-arm fluoroscopy during spine surgery. . An 81-year-old-female underwent a posterior spinal fixation L2-S1 due to lumbar spinal stenosis. In the recovery room, she presented an hematoma at the posterolateral part of her arm associated with a wrist drop due to radial nerve neuropraxis. The patient was referred to an occupational therapist and fully recovered four months later. After analysis of the patient positioning during the intervention, we came to the conclusion that this radial nerve injury was very possibly due to a compression by the C-arm fluoroscopy during the surgery.
Our case describes a rare case of compression of the radial nerve during lumbar spine surgery, which is an unexpected complication as the site of the nerve injury is not at all related to the surgery itself, but to the position of the patient. Although C-arm fluoroscopy is essential, spine surgeons should be aware of this possible complication related to its use in order to avoid it.
周围神经损伤是一种与患者体位相关的常见手术并发症。此外,在脊柱手术中,长时间处于俯卧位会增加患者的风险。本研究的目的是报告一例在脊柱手术期间因C型臂透视压迫导致桡神经失用的病例。一名81岁女性因腰椎管狭窄接受了L2 - S1后路脊柱固定术。在恢复室,她的手臂后外侧出现血肿,并因桡神经失用导致垂腕。该患者被转介给职业治疗师,四个月后完全康复。在分析干预过程中的患者体位后,我们得出结论,这种桡神经损伤很可能是由于手术期间C型臂透视的压迫所致。
我们的病例描述了腰椎手术期间桡神经受压的罕见情况,这是一种意外的并发症,因为神经损伤部位与手术本身毫无关系,而是与患者体位有关。尽管C型臂透视至关重要,但脊柱外科医生应意识到与其使用相关的这种可能并发症,以避免发生。