Cervical cord compression caused by a pillow in a postlaminectomy patient undergoing magnetic resonance imaging. Case report.
A 66-year-old man, who had undergone osteoplastic laminectomy for posttraumatic cervical myelopathy, underwent a second operation in which the replaced laminae were removed because of postoperative deep wound infection. Follow-up dynamic magnetic resonance imaging with flexion and extension views of the neck 1 year postsurgery demonstrated that the cervical cord was markedly compressed from behind in the extended position, although a wide subarachnoid space was observed in this region when the neck was in the flexed position. The cause of cord compression was the pillow that was placed underneath the patient's neck for maintaining the extended position, not the neck extension itself. This finding indicates that care must be taken during neuroradiological examination not to place a pillow under the neck of a patient who has undergone laminectomy. Nuchal compression could lead to cervical cord injury after laminectomy. Laminoplasty benefits the patient by protecting the cervical cord from secondary injury.
Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan. fsuzuki@belle.shiga-med.ac.jp
F
F
Suzuki
M
M
Nakajima
M
M
Matsuda
D000368:Aged; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D012086:Reoperation; D013117:Spinal Cord Compression / Q000209:etiology*; D013530:Surgical Wound Infection / Q000601:surgery*