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Spinal cord injury following operative shoulder intervention: A case report
Authors:Christine Cleveland  Heather Walker
Institution:Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Abstract:

Context

Cervical myelopathy is a spinal cord dysfunction that results from extrinsic compression of the spinal cord, its blood supply, or both. It is the most common cause of spinal cord dysfunction in patients greater than 55 years of age.

Findings: A

57-year-old male with right shoulder septic arthritis underwent surgical debridement of his right shoulder and sustained a spinal cord injury intraoperatively. The most likely etiology is damage to the cervical spinal cord during difficult intubation requiring multiple attempts in this patient with underlying asymptomatic severe cervical stenosis.

Conclusion

Although it is not feasible to perform imaging studies on all patients undergoing intubation for surgery, this patient''s outcome would suggest consideration of inclusion of additional pre-surgical screening examination techniques, such as testing for a positive Hoffman''s reflex, is appropriate to detect asymptomatic patients who may have underlying cervical stenosis.
Keywords:Spinal cord injury  Cervical stenosis  Hoffmann''s reflex  Intubation
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