Paraplegia caused by posture during MRI in a patient with cervical disk herniation.
A 48-year-old man presented with numbness in the lower left extremity of 4 months' duration. One month earlier, he presented to an orthopedic clinic and magnetic resonance imaging (MRI) revealed cervical disk herniation. Because the pain did not subside, he visited the clinic again and MRI was performed. His neck was slightly extended and fixed to the headrest of the MRI instrument. Because of the posture of his cervical spine, he suffered severe pain in the scapular region during the MRI. After 15 minutes the pain was unbearable and the MRI examination was aborted. As the patient tried to descend from the MRI table, he was unable to move his bilateral lower extremities. No muscle contraction was observed in his lower limbs. Following MRI with flexion posture of the cervical spine, he was diagnosed with paraplegia caused by cervical disk herniation. Emergency surgery consisting of anterior decompression and fusion was performed. The patient showed good neurological recovery. Three weeks postoperatively, the patient could walk without assistance and he was discharged. The extension posture of the cervical spine during MRI was considered to be the cause of acute paraplegia in this patient. Care should be taken with the posture of the cervical spine, when performing MRI in patients with cervical disk herniation. Extended posture of the cervical spine during MRI may lead to acute neurological deterioration.
Kato
Yoshihiko
Y
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. kato-yo@yamaguchi-u.ac.jp
Nishida
Norihiro
N
Taguchi
Toshihiko
T
D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology* / Q000601:surgery; D011187:Posture; D013123:Spinal Fusion / Q000379:methods