Transient paraparesis after laminectomy in a patient with multi-level ossification of the spinal ligament.
Acute neurologic deterioration is not a rare event in the surgical decompression for thoracic spinal stenosis. We report a case of transient paraparesis after decompressive laminectomy in a 50-yr-old male patient with multi-level thoracic ossification of the ligamentum flavum and cervical ossification of the posterior longitudinal ligament. Decompressive laminectomy from T9 to T11 was performed without gross neurological improvement. Two weeks after the first operation, laminoplasty from C4 to C6 and additional decompressive laminectomies of T3, T4, T6, and T8 were performed. Paraparesis developed 3 hr after the second operation, which recovered spontaneously 5 hr thereafter. CT and MRI were immediately performed, but there were no corresponding lesions. Vascular compromise of the borderlines of the arterial supply by microthrombi might be responsible for the paraparesis.
Lee
Kyeong-Seok
KS
Department of Neurosurgery, Soonchunhyang University Chonan Hospital, Chonan, Korea. kslshl@schch.co.kr
Shim
Jae-Jun
JJ
Doh
Jae-Won
JW
Yoon
Seok-Mann
SM
Bae
Hack-Gun
HG
Yun
Il-Gyu
IG
D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000009:adverse effects; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D017843:Ligamentum Flavum / Q000473:pathology / Q000601:surgery; D017846:Longitudinal Ligaments / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic; D020335:Paraparesis / Q000209:etiology*