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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Delayed spinal cord infarction following anterior cervical surgical decompression
  1. Muhammad Faheem Khan1,
  2. Rashid Jooma1,
  3. Fauzan Alam Hashmi1,
  4. Muhammad Faraz Raghib2
  1. 1Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  2. 2Medical College, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Muhammad Faheem Khan, dr.mfaheemkhan{at}gmail.com

Summary

Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5–6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5–6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause. We have reviewed similar cases reported in the literature and believe that our patient’s postsurgical course is consistent with a delayed ischaemic/reperfusion injury to the cord following surgical decompression and restoration of blood flow through the anterior spinal artery and we make suggestions for management of such clinical events.

  • mechanical ventilation
  • neuroimaging
  • neurological injury
  • spinal cord
  • neurosurgery

https://doi.org/10.1136/bcr-2017-219863

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    Footnotes

    • Contributors MFK was the primarily assistant in the surgery and was involved in writing the manuscript and literature search. FAH was involved in literature search and helped in writing the discussion. RJ was the primary surgeon and involved in idea, review and correction of the manuscript. MFR was involved in obtaining the radiological pictures and helped in writing the case presentation.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.