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Tetraplegia After Thyroidectomy in a Patient with Cervical Spondylosis A Case Report and Literature Review

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单位: [1]Huazhong Univ Sci & Technol,Dept Orthoped Surg,Tongji Hosp,Tongji Med Coll,Wuhan 430074,Peoples R China
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Cervical spondylosis is degeneration of the cervical spine that occurs during the normal course of aging, and may progress into compression of the spinal cord, or cervical spondylotic myelopathy (CSM), which can cause neurologic dysfunction. Cervical spondylosis can be identified in the majority of people older than 50 years. Many people with cervical spondylosis or CSM are asymptomatic. However, patients with CSM are at higher risk of spinal cord injury (SCI) following minor injury. A 60-year-old woman with asymptomatic cervical spondylosis underwent an elective subtotal thyroidectomy for thyroid nodules. After the surgery, she developed tetraplegia. MRI revealed spinal cord compression and injury. Main diagnoses, therapeutics interventions, and outcomes: Acute cervical SCI was diagnosed. After an emergency anterior cervical corpectomy and fusion surgery, she almost completely recovered. Iatrogenic cervical SCI after nonspinal surgeries that requires neck hyperextension is rarely reported, probably due to underdiagnosis and underreport. Among the 14 cases (including ours) published in the literature, most patients had cervical spondylosis and were senior men. Five patients had diabetes. Four patients had long-term hemodialysis. Seven patients had undergone coronary artery bypass surgery that requires prolonged operative time. Only 3 patients had almost complete recovery. Most patients were disabled. Two patients required tracheostomy for long-term ventilator support. Two patients died. These cases reiterate the potential risk of iatrogenic SCI in people with predisposing conditions such as cervical spondylosis, especially considering the rising prevalence and severity of cervical spondylosis caused by the aging of the population and modern sedentary lifestyle. Surgeries requiring prolonged neck hyperextension put patients with cervical spondylosis at risk for SCI. Failure to recognize the potential occurrence of iatrogenic SCI might endanger patients' lives.

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出版当年[2014]版:
大类 | 2 区 医学
小类 | 2 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2013]版:
Q1 MEDICINE, GENERAL & INTERNAL
最新[2024]版:
Q2 MEDICINE, GENERAL & INTERNAL

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第一作者单位: [1]Huazhong Univ Sci & Technol,Dept Orthoped Surg,Tongji Hosp,Tongji Med Coll,Wuhan 430074,Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol,Dept Orthoped Surg,Tongji Hosp,Tongji Med Coll,Wuhan 430074,Peoples R China [*1]Tongji Hosp,Dept Orthoped Surg,1095 Jiefang Ave,Wuhan 430030,Peoples R China
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