Spinal Cord Injury Following Abdominal Aortic Surgery: A Case Report

Abstract

The incidence of spinal cord injury following abdominal aortic surgery is 0.25%.⁸ Szilagyi's world literature search yielded 36 case reports, and he added 8 case reports to that number. In Szilagy's series, all of the postoperative cases of spinal cord injury were observed after abdominal aortic aneurysm surgery. The incidence in cases of ruptured aneurysms was ten times greater (5 of 247 or 2%) than that noted in cases of unruptured aneurysms (3 of 1,477 or 0.2%) . No spinal cord injury occurred in the patients operated on for aorto-iliac occlusive disease, and the rarity of occurrence of this complication in aorto-iliac occlusive disease is reflected in the number of cases reported in the literature. ^2,3,5,6,9

The lower extremity neurologic deficit may occur with or without bowel and bladder paralysis, and may be temporary or permanent. The object of this paper is to present a case report of spinal cord injury following surgery for aorto-iliac occlusive disease, and a discussion of the pathophysiology of this complication.

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References

Djindjian R. , Faure C. : Accidents Medullaires de l'aortographie. J Belg Radiol 50: 207, 1967.

Ferguson Lrj , Bergan JJ , Conn J. Jr, et al: Spinal ischemia following abdominal aortic surgery. Ann Surg 181: 267, 1975.

Lake PA : Paraplegia after resection of aneurysm (Letter to the Editor). N Engl J Med 281: 798, 1969.

Kaydi H. : Ueber die Blutgedasse des Menschlicken Ruckenmarkes, Nach Einer Im XV. Bande der Kenkschriften der Math Natur Classe der Akad d. Wissenschaften in Krakau Erschienin Nonographie, 1889.

Scorza R. , Berardinelli L. , Odero A. : Su un Caso di paraplegia successivo a clampaggio dell'aorta sottorenale. Minerva Cardioangiol 23: 692, 1975.

Smith RA : Neurological complications of extraspinal arterial origin. Am Surg 42: 679, 1976.

Suh TH and Alexander L. : Vascular system of human spinal cord. Arch Neurol Psych 41: 659, 1939.

Szilagyi DE , et al: Spinal cord damage in surgery of the abdominal aorta. Surgery 83: 38, 1978.

Zuber WF , Gaspar MR , Rothchild PD : The anterior spinal artery syndrome-A complication of abdominal aortic surgery: Report of five cases and review of the literature. Ann Surg 172: 909, 1970.