Mortality and morbidity associated with correction of severe cervical hyperextension.
METHODS
Three case reports of patients with treatment of severe cervical hyperextension.


OBJECTIVE
Cervical hyperextension is a rare spine deformity that is associated with myopathies. Previous reports of surgical correction have reported no major operative complications. This report outlines our experience with 3 patients who experienced significant complications.


BACKGROUND
The limited literature on the treatment of cervical hyperextension has good to excellent outcomes.


METHODS
Three case reports are presented.


RESULTS
Three cases with severe cervical hyperextension with intraoperative correction had associated morbidity and mortality. One case had a failed intubation requiring tracheotomy. This was followed by a successful posterior release with halo traction for 2 weeks and then an instrumented posterior cervical fusion. This patient died at home 2 weeks after surgery. The second and third cases had an intraoperative spinal cord injury during a posterior release for cervical hyperextension.


CONCLUSIONS
Patients with severe cervical hyperextension have high neurologic perioperative risk.
Poulter
Gregory T
GT
Department of Orthopedic Surgery, University of California, San Francisco, CA, USA.
Garton
Hugh J L
HJ
Blakemore
Laurel C
LC
Hensinger
Robert N
RN
Graziano
Gregory P
GP
Farley
Frances A
FA
D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical; D017809:Fatal Outcome; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery; D007796:Laminectomy; D008141:Lordosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000601:surgery; D049288:Muscular Dystrophies, Limb-Girdle / Q000150:complications / Q000601:surgery; D020389:Muscular Dystrophy, Emery-Dreifuss / Q000150:complications / Q000601:surgery; D020512:Myopathy, Central Core / Q000150:complications / Q000601:surgery; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011782:Quadriplegia / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects*; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery; D014143:Traction; D016896:Treatment Outcome