title: Delayed anterior spinal artery syndrome following posterior scoliosis correction.
abstract: The authors report two cases of delayed post-operative anterior spinal artery syndrome (ASAS) following posterior correction with Cotrel Dubousset (CD) instrumentation for adolescent idiopathic scoliosis. Sensory pathways were continuously monitored from skin incision to awakening. In both cases intraoperative SEPs were normal and the wake-up test revealed no neurological deficit. Both patients were presented with incomplete paraplegia (no sensory impairment) three and ten hours after surgery. Without delay, both patients underwent revision surgery, and the CD instrumentation was removed. Immediately after surgery, both patients' motor power in their lower extremities improved rapidly. In cases with delayed ASAS after posterior scoliosis correction, the removal of the instrumentation system was shown to be sufficient to regain full motor recovery caudal to the level of impairment.
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Austria. bernd.stoeckl@uibk.ac.at
authors.forename: Bernd
authors.initials: B
authors.lastname: Stöckl
authors.forename: Cornelius
authors.initials: C
authors.lastname: Wimmer
authors.forename: Petra
authors.initials: P
authors.lastname: Innerhofer
authors.forename: Markus
authors.initials: M
authors.lastname: Kofler
authors.forename: Hannes
authors.initials: H
authors.lastname: Behensky
mesh_terms: D000293:Adolescent; D020759:Anterior Spinal Artery Syndrome / Q000209:etiology* / Q000601:surgery; D020878:Device Removal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010264:Paraplegia / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D013997:Time Factors