Journal of neurological surgery. Part A, Central European neurosurgery · 2019
Multilevel Spinal Combined Subdural/Subarachnoid Hemorrhage Resulting in Paraplegia: An Unusual Complication of Kyphoplasty.
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von der Brelie C, Fiss I, Rohde V
Аннотация
BACKGROUND: Paraplegia due to spinal combined subdural/subarachnoid hemorrhage is an extremely rare complication following percutaneous spinal augmentation procedures.
METHODS: A 63-year-old male patient presented with severe neurologic decline (paraplegia with sensory and autonomic dysfunction) resulting from a multilevel spinal subarachnoid hemorrhage shortly after bilateral kyphoplasty.
RESULTS: Reduction of intrathecal pressure via multiple dural and arachnoidal incisions and removal of the hematoma resulted in a good neurologic recovery with surgical decompression even though evacuation was performed with a significant delay after the onset of neurologic worsening.
CONCLUSION: Spinal augmentation procedures should only be performed in a setting where management of complications can also be diagnosed and performed. Robot-assisted or navigation-assisted pedicle perforation should be considered because complications can be reduced significantly.
METHODS: A 63-year-old male patient presented with severe neurologic decline (paraplegia with sensory and autonomic dysfunction) resulting from a multilevel spinal subarachnoid hemorrhage shortly after bilateral kyphoplasty.
RESULTS: Reduction of intrathecal pressure via multiple dural and arachnoidal incisions and removal of the hematoma resulted in a good neurologic recovery with surgical decompression even though evacuation was performed with a significant delay after the onset of neurologic worsening.
CONCLUSION: Spinal augmentation procedures should only be performed in a setting where management of complications can also be diagnosed and performed. Robot-assisted or navigation-assisted pedicle perforation should be considered because complications can be reduced significantly.