Aminophylline for the treatment of symptomatic bradycardia and asystole secondary to cervical spine injury.

INTRODUCTION

Bradycardia is a common complication of cervical spine damage in the weeks following injury, occurring in up to 100% of patients in some studies. Cardiac arrest and asystole have been reported in as many as 15% of these patients and cardiac events are the main cause of death within the first year. We describe the case of a 25-year-old African-American male involved in a motor vehicle collision who suffered C6-C7 subluxation.

METHODS

Following cervical discectomy and spinal fusion the patient began to develop progressive bradycardia culminating on hospital day 20 with two asystolic events requiring atropine administration. In an attempt to prevent further events and generate hemodynamic stability, aminophylline therapy was initiated.

RESULTS

Following day two of therapy, the patient's bradycardia resolved, and no further asystolic events occurred.

CONCLUSION

There is limited evidence for the use of methylxanthines in the treatment of bradycardia associated with spinal cord injury. In patients with recurrent asystolic events or symptomatic bradycardia the use of these agents should be considered.