Delayed presentation of tetraparesis following posterior thoracolumbar spinal fusion and instrumentation for adolescent idiopathic scoliosis.
METHODS
Case report.


OBJECTIVE
We present a case of delayed tetraparesis in a patient after posterior spinal fusion for adolescent idiopathic scoliosis.


BACKGROUND
The reported rate of neural complications after scoliosis surgery is low. Intraoperative neuromonitoring is used to detect and prevent spinal cord injury.


METHODS
Review of medical record.


RESULTS
Delayed tetraparesis developed on the second postoperative day after unremarkable T3-L4 posterior fusion. MRI revealed evidence of cord ischemia at C4-C7. Angiogram revealed a hypervascular T4 body resulting in arteriovenous shunting into the epidural venous plexus.


CONCLUSIONS
Venous congestive myelopathy due to arteriovenous shunting or unrecognized syrinx are presented as possible etiologies of this patient's spinal cord injury. A preoperative MRI may have helped discern the cause of this patient's spinal cord injury.
Dapunt
Ulrike A
UA
Department of Orthopaedic Surgery, University of California, San Francisco, CA 94143, USA.
Mok
James M
JM
Sharkey
Melinda S
MS
Davis
Alexander A
AA
Foster-Barber
Audrey
A
Diab
Mohammad
M
D002648:Child; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D010291:Paresis / Q000175:diagnosis* / Q000209:etiology; D012600:Scoliosis / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D013123:Spinal Fusion / Q000009:adverse effects*; D013904:Thoracic Vertebrae / Q000601:surgery