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.
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.
Authors: Alejandro Quinonez; Joshua M Pahys; Amer F Samdani; Steven W Hwang; Patrick J Cahill; Randal R Betz Journal: Spinal Cord Ser Cases Date: 2021-04-20