title: Transient paralysis shortly after anterior cervical corpectomy and fusion.
abstract: OBJECTIVE
  To report three cases of transient paralysis shortly after (within 4 hours) anterior cervical corpectomy and fusion (ACCF), and investigate the possible causes.
  
  
  METHODS
  Clinical and radiological data of three cases (two men and one woman, aged 41-61 years) were analyzed retrospectively. All three patients underwent ACCF for cervical spondylotic myelopathy. The decompressed segments were located in C(5) , C(6) and C(5) + C(6-7) discs, respectively. Paralysis occurred from 30 minutes to 4 hours after surgery. In two cases the paralysis was complete; it was incomplete in the third. All patients received immediate dehydration, neurotrophic drugs and high-dose methylprednisolone therapy upon recognition of their paralysis. Meanwhile, cervical MRIs were performed and showed no significant hematomas compressing the cervical spinal cord; spinal cord edema was clearly evident in all cases.
  
  
  RESULTS
  In two cases the paralysis resolved within 2 hours of diagnosis and immediate medication. In the third case, because the neurological symptoms were incompletely resolved 24 hours after beginning medication, a second laminoplasty was performed. During decompression, tremendous pressure was released from the cervical spinal cord. The neurological symptoms had resolved completely by 1 week after decompression.
  
  
  CONCLUSIONS
  The precise cause for transient paralysis after these anterior cervical surgeries is not yet clear. Spinal cord ischemia-reperfusion injury is generally regarded as the most likely cause. Therefore, a combination of cervical spinal cord edema and limited anterior decompression space may have been the main contributing factors to the paralysis reported here. Early diagnosis and early intervention to relieve the paralysis can restore spinal cord function and result in a satisfactory prognosis.
authors: Department of Spine Surgery, Tianjin Hospital, Tianjin, China. bird0496@sina.com
authors: Ji-dong
authors: JD
authors: Zhang
authors: Qun
authors: Q
authors: Xia
authors: Ning
authors: N
authors: Ji
authors: Yan-cheng
authors: YC
authors: Liu
authors: Yue
authors: Y
authors: Han
authors: Shang-long
authors: SL
authors: Ning
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome