Ramírez-Aragón Sergio, Del Pino-Camposeco Jorge, Villanueva-Castro Eliezer, Canela-Calderon Obet, Arriada-Mendicoa Juan Nicasio, Ponce-Gómez Juan Antonio
Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Cureus. 2023 Dec 24;15(12):e51034. doi: 10.7759/cureus.51034. eCollection 2023 Dec.
We present the case of a 32-year-old woman with a diagnosis of lumbar root syndrome and spondylolisthesis, which is why she underwent surgery. Anterior discectomy and intersomatic box placement plus posterior fixation were performed with percutaneous transpedicular screws in L5-S1. At 24 hours of the procedure, the patient presents sustained hypotension, adding sudden and intense chest pain with neck irradiation, dyspnea, and diaphoresis, as well as electrocardiographic abnormalities and elevation of cardiac enzymes suggestive of an acute coronary syndrome, subsequently evidence of basal hypokinesis in the echocardiogram. After providing hemodynamic support and analgesic management, the symptoms were resolved, and the electrocardiogram (ECG) and cardiac enzymes were normalized, allowing an adequate postoperative evolution.
我们报告一例32岁女性患者,诊断为腰椎神经根综合征和腰椎滑脱,因此接受了手术。在L5-S1节段行经皮椎弓根螺钉置入术,进行前路椎间盘切除术、椎间融合器置入及后路固定。手术24小时时,患者出现持续性低血压,伴有突发剧烈胸痛并向颈部放射、呼吸困难、多汗,以及心电图异常和心肌酶升高,提示急性冠状动脉综合征,随后超声心动图显示基底段运动减弱。在给予血流动力学支持和镇痛处理后,症状缓解,心电图和心肌酶恢复正常,术后病情顺利进展。