Korean J Anesthesiol.  1998 Oct;35(4):795-799. 10.4097/kjae.1998.35.4.795.

Paraplegia Following Percutaneous Nephrolithotomy under General Anesthesia: A case report

• Shim HR
• Lee PH
• Hwang JH

• KMID: 2091293
• DOI: http://doi.org/10.4097/kjae.1998.35.4.795

Abstract

We present a case of paraplegia, compatible with spinal cord ischemia, following percutaneous nephrolithotomy in a 58-year-old male under the diagnosis of left renal stone. After retroperitoneal operative procedures in the prone position, sensory loss below the level of T4, paraplegia and transient loss of visual acuity were developed. These clinical findings reflect ischemia of the anterior spinal cord with complete motor paralysis and sensory loss to T4 dermatomal level resulting from an anterior spinal artery syndrome. The initial treatment was started with intravenous heparin and corticosteroid. At present, sensory loss is almost recovered and motor deficit is remarkably improved to a level of ambulation with cane. The patient is still treated with oral coumadine and neuromotor rehabilitation. The cause of spinal cord ischemia is unknown, but we speculate ischemia of the spinal cord was associated with embolism and spasm or trauma of feeding artery (ies) of Adamkiewicz.

Keyword

Complications: central nervous system; hypoxia; postoperative; Spinal cord: paraplegia

MeSH Terms

Anesthesia, General*
Anterior Spinal Artery Syndrome
Arteries
Canes
Diagnosis
Embolism
Heparin
Humans
Ischemia
Male
Middle Aged
Nephrostomy, Percutaneous*
Paralysis
Paraplegia*
Prone Position
Rehabilitation
Spasm
Spinal Cord
Spinal Cord Ischemia
Surgical Procedures, Operative
Visual Acuity
Walking
Warfarin
Heparin
Warfarin