Delayed presentation of tetraparesis following posterior thoracolumbar spinal fusion and instrumentation for adolescent idiopathic scoliosis

Ulrike A. Dapunt, James M. Mok, Melinda S. Sharkey, Alexander A. Davis, Audrey Foster-Barber, Mohammad Diab

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Study Design: Case report. Objective: We present a case of delayed tetraparesis in a patient after posterior spinal fusion for adolescent idiopathic scoliosis. Summary of Background Data: The reported rate of neural complications after scoliosis surgery is low. Intraoperative neuromonitoring is used to detect and prevent spinal cord injury. Methods: Review of medical record. Results: Delayed tetraparesis developed on the second postoperative day after unremarkable T3-L4 posterior fusion. MRI revealed evidence of cord ischemia at C4-C7. Angiogram revealed a hypervascular T4 body resulting in arteriovenous shunting into the epidural venous plexus. Conclusion: Venous congestive myelopathy due to arteriovenous shunting or unrecognized syrinx are presented as possible etiologies of this patient's spinal cord injury. A preoperative MRI may have helped discern the cause of this patient's spinal cord injury.

Original languageEnglish (US)
Pages (from-to)E936-E941
JournalSpine
Volume34
Issue number25
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Keywords

  • Adolescent idiopathic scoliosis
  • Arteriovenous fistula
  • Complications
  • Fusion
  • Paraplegia
  • Spinal cord injury
  • Tetraparesis
  • Venous congestive myelopathy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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