title: Spinal cord ischemia resulting in paraplegia following extrapleural pneumonectomy.
abstract: A patient undergoing radical extrapleural pneumonectomy for epithelioid malignant mesothelioma developed acute paraplegia postoperatively related to long-segment spinal cord ischemia. The usual area of concern for this complication is the T9 to T12 area where the artery of Adamkiewicz is most likely to originate. In this patient, there was ligation of only upper thoracic, ipsilateral segmental arteries from the T3 to T6 level, yet he still developed paraplegia. Our hypothesis is variant mid-thoracic vascular anatomy. Previously unreported, to our knowledge, this should be understood as a rare complication of this surgery.
authors.affiliation: Department of Anesthesiology, Ochsner Health System, New Orleans, LA. Electronic address: kural@ochsner.org.
authors.forename: Kelly
authors.initials: K
authors.lastname: Ural
authors.affiliation: Department of Surgery, Ochsner Health System, New Orleans, LA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Jakob
authors.affiliation: Department of Anesthesiology, Ochsner Health System, New Orleans, LA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lato
authors.affiliation: Department of Anesthesiology, Ochsner Health System, New Orleans, LA.
authors.forename: George
authors.initials: G
authors.lastname: Gilly
authors.affiliation: Department of Surgery, Ochsner Health System, New Orleans, LA.
authors.forename: Rodney
authors.initials: R
authors.lastname: Landreneau
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000601:surgery*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology*; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D020760:Spinal Cord Ischemia / Q000150:complications* / Q000175:diagnosis; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed