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脊柱后凸-侧凸畸形矫正术中中心静脉置管所致臂丛神经损伤

Brachial Plexus Injury due to Central-line Insertion during Kypho-scoliosis Deformity Correction.

作者信息

Modi Hitesh N, Goel Shakti A, Sharma Arvind, Patel Udit

机构信息

Department of Orthopaedics and Spine Surgery, Zydus Hospitals and Healthcare Research Pvt. Ltd., Thaltej, Ahmedabad, Gujarat, India.

Department of Neurology, Zydus Hospitals and Healthcare Research Pvt. Ltd., Ahmedabad, Gujarat, India.

出版信息

J Orthop Case Rep. 2021 Jul;11(7):41-44. doi: 10.13107/jocr.2021.v11.i07.2308.

Abstract

INTRODUCTION

Internal Jugular Venous (IJV) cannulation or central-line insertion is frequently performed during kyphoscoliosis deformity correction surgery or spine surgery with high risk. This helps monitor central venous pressure and administer medicines when required. Although many complications of IJV cannulation have been reported in the literature, its effect on brachial plexus is not known. The objective of this paper was to report a rare complication of IJV during scoliosis surgery.

CASE PRESENTATION

We reported a case of 27-year-old male who was operated for severe kyphoscoliosis correction where preoperatively IJV cannulation was done. Repeated attempts were done during IJV cannula insertion due to altered anatomy. Eventually, cannula insertion was done using ultrasound modality and surgery for correction was done. Postoperatively patient developed right upper extremity weakness and sensory loss although the clinical result of kyphoscoliosis correction was acceptable. EMG-NCV study proved it brachial plexus injury. The patient was treated with intravenous steroid and physiotherapy. The patient recovered completely within 6 months of surgery.

CONCLUSION

We reported a case of kyphoscoliosis deformity corrective surgery where IJV cannulation led to brachial plexus injury and was eventually recovered with medications and physiotherapy.

摘要

引言

在脊柱侧弯畸形矫正手术或高风险脊柱手术期间,经常进行颈内静脉(IJV)插管或中心静脉置管。这有助于监测中心静脉压并在需要时给药。尽管文献中已报道了IJV插管的许多并发症,但其对臂丛神经的影响尚不清楚。本文的目的是报告脊柱侧弯手术期间IJV的一种罕见并发症。

病例介绍

我们报告了一例27岁男性,因严重脊柱后凸侧弯矫正手术进行了术前IJV插管。由于解剖结构改变,在IJV插管过程中进行了多次尝试。最终,使用超声方式完成了插管,并进行了矫正手术。术后患者出现右上肢无力和感觉丧失,尽管脊柱后凸侧弯矫正的临床结果是可以接受的。肌电图-神经传导速度研究证实为臂丛神经损伤。患者接受了静脉注射类固醇和物理治疗。患者在手术后6个月内完全康复。

结论

我们报告了一例脊柱后凸侧弯畸形矫正手术,其中IJV插管导致臂丛神经损伤,最终通过药物治疗和物理治疗得以康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/8576778/4c1174381a6a/JOCR-11-41-g001.jpg

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