Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis

Firooznia, Hossein; Ahn, Jung Hwan; Rafii, Mahvash; Ragnarsson, Kristian T.

doi:10.1016/0090-3019(85)90337-4

Cited by 53 publications

(18 citation statements)

References 11 publications

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“…Sudden quadriplegia has been reported after minor trauma in a patient with preexisting critical spinal stenosis, in the absence of anesthesia. 11 In conclusion, we report a case of CES after a TURP under spinal anesthesia in the lithotomy position. The patient was found to have severe LSCS from facet joint synovial cysts.…”

Section: Discussionmentioning

confidence: 75%

Synovial cysts and the lithotomy position causing cauda equina syndrome

Wills

Wiesel

Abram

et al. 2004

Regional Anesthesia and Pain Medicine

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We describe a case of cauda equina syndrome caused by synovial cysts and the lithotomy position. A transurethral resection of the prostate was performed under spinal anesthesia in the lithotomy position. We believe that this is the first case report of facet joint synovial cysts and the lithotomy position causing ischemic neurologic injury to the cauda equina. Other etiologies such as needle trauma, neurotoxicity, hematoma, and abscess were not evident. We believe that positioning the patient in the lithotomy position narrowed the cross-sectional area of the spinal canal in a patient with a coexisting critically stenosed lumbar spinal canal. The resultant mechanical pressure caused an ischemic compression injury to the cauda equina.

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Section: Discussionmentioning

confidence: 75%

Synovial cysts and the lithotomy position causing cauda equina syndrome

Wills

Wiesel

Abram

et al. 2004

Regional Anesthesia and Pain Medicine

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“…6,19 These degenerative changes could allow for damage to the neural structures by excessive traction or pinching during the accident. 6,13,19,21,22 SCIWORET patients frequently present with central cord syndrome. 13,19,23 Therefore, an eventual neurological dysfunction is most likely to affect the upper extremities and especially the hands.…”

Section: Discussionmentioning

confidence: 99%

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Wenger

Pj²,

Alarcón³

et al. 2003

Spinal Cord

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Study design: A case report of blunt cervical spine trauma associated with cord oedema at the C3/C4 level with temporary Frankel/American Spinal Injury Association Grade A quadriparesis and motion segment instability without evidence of associated bony lesions (spinal cord injury without radiological abnormality, SCIWORA lesion). Objectives: By means of a rare and illustrative case, the reader's attention is focused on eventual marked cervical motion segment instability in SCIWORA patients. Setting: A department of Neurology in Quito, Ecuador and a department of Neurosurgery in Bern, Switzerland. Method: A 73-year-old man sustained blunt cervical spine trauma. After resolution of paraparesis, dynamic studies of the cervical spine revealed translational instability of C3 over C4. The patient underwent segment fusion by intervertebral cage insertion and plate fixation. Results: The patient had recovered almost completely from tetraparesis under conservative treatment. The postoperative course was uneventful. Solid bony fusion of the C3/C4 motion segment was obtained. Conclusion: Despite normal cervical alignment, the lack of bony lesions and neurological recovery, magnetic resonance imaging and dynamic studies may reveal marked translational cervical motion segment instability requiring segment fusion in order to prevent ongoing damage of the spinal cord.

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“…3) and degenerative changes are seen in the Klippel-Feil syndrome above and below the fused vertebrae [7]. When there is coexisting malalignment and/or a developmental narrow canal, hypermobility and excessive translation may be critical in producing recurrence [9,10,12,26]. Posterior spondylolisthesis, or increased posterior vertebral translation, may cause a pincer action on the spinal cord when the neck is extended, again with a high chance of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy

Baba

Furusawa

Imura

et al. 1994

International Orthopaedics

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Eighteen patients with spondylotic myeloradiculopathy who had undergone expansive laminoplasty after anterior cervical fusion were reviewed. The average period from the initial to the second operation was 7.8 years. Excellent neurological improvement occurred in 4 patients, good in 6, fair in 4 and poor in 4. Radiographs at the time of the second operation showed spinal canal stenosis in 11, and 12 showed dynamic spinal canal stenosis immediately above the fused area. A narrow spinal canal adds to the risk of recurrence. When spinal stenosis is treated by anterior cervical fusion, additional laminoplasty should be carried out to prevent structural compromise occurring adjacent to the fused vertebrae.

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Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis

Cited by 53 publications

References 11 publications

Synovial cysts and the lithotomy position causing cauda equina syndrome

Synovial cysts and the lithotomy position causing cauda equina syndrome

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy

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