Kim Kyung Hoon, Kim Pius, Kim Seok Won
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Korean J Neurotrauma. 2022 Mar 10;18(1):132-136. doi: 10.13004/kjnt.2022.18.e12. eCollection 2022 Apr.
Most spine surgeons and anesthesiologists believe that the risk of spinal cord injury (SCI) during intubation is mainly due to mechanical compression of the spinal cord due to cervical spine movement in cases of undiagnosed but severe cervical lesions. With this reasoning, difficult intubation, which is more frequently encountered in patients with preexisting cervical diseases, is likely to result in SCI. Several reports have described SCI after non-cervical surgery in patients previously diagnosed with cervical myelopathy and a chronically compressed cervical cord; however, to date, there is less acknowledgement of SCI in patients with undiagnosed cervical myelopathy. Here, we report a painful experience of neurological deterioration that developed immediately after elective lumbar decompressive surgery in a 76-year-old man. The possible mechanism behind these unexpected complications is discussed in a review of the literature.
大多数脊柱外科医生和麻醉医生认为，在插管过程中发生脊髓损伤（SCI）的风险主要是由于在未诊断出但存在严重颈椎病变的情况下，颈椎活动导致脊髓受到机械性压迫。基于这种推理，在已有颈椎疾病的患者中更常遇到的困难插管很可能导致SCI。有几份报告描述了先前被诊断患有颈椎脊髓病和慢性受压颈髓的患者在非颈椎手术后发生SCI的情况；然而，迄今为止，未诊断出颈椎脊髓病的患者发生SCI的情况较少得到认可。在此，我们报告一名76岁男性在择期腰椎减压手术后立即出现神经功能恶化的痛苦经历。在文献综述中讨论了这些意外并发症背后的可能机制。
