Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson's Disease, and Torticollis: Surgical Management.
Sarah MerrillMaziyar A KalaniNaresh P PatelMark K LyonsMatthew T NealPublished in: Case reports in orthopedics (2020)
Case Report. Spine surgery in patients with Parkinson's disease (PD) involves increased risk. We describe a case of cervical myelopathy in a patient with PD, multiple fractures involving the atlas and axis vertebrae, and spasmodic torticollis. The patient was successfully treated with an upper cervical decompression and occipital-cervical (OC) fusion surgery. Strategies for torticollis reduction and successful surgical outcome are discussed. Risks and benefits must be carefully weighed when considering occipital cervical fusion in PD patients. Conclusion. Intraoperative manual reduction of laterocollis is possible after general endotracheal anesthesia, and continuous neuromonitoring is established. Use of optimizing strategies such as perioperative botulinum injections and intraoperative O-arm navigation should be considered.
Keyphrases
- case report
- spinal cord
- end stage renal disease
- minimally invasive
- patients undergoing
- ejection fraction
- newly diagnosed
- liver failure
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- cardiac surgery
- climate change
- respiratory failure
- intensive care unit
- ultrasound guided
- acute coronary syndrome
- acute kidney injury
- patient reported outcomes
- drug induced
- extracorporeal membrane oxygenation
- patient reported
- aortic dissection