J Korean Orthop Assoc.  2020 Dec;55(6):534-539. 10.4055/jkoa.2020.55.6.534.

Sixth Cranial Nerve (Abducens Nerve) Palsy after Preoperative Halo-Pelvic Traction for Severe Scoliosis with Chiari I Malformation

• Hwang JK
• Lee CS
• Choi SW
• Kim CH

• KMID: 2509627
• DOI: http://doi.org/10.4055/jkoa.2020.55.6.534

Abstract

The management of severe scoliosis remains a challenge to spine surgeons. The rapid intraoperative correction of severe scoliosis may increase the risk of perioperative complications, such as neurological compromise and implant failure. To minimize these risks, various preoperative traction methods have been employed to achieve partial correction before performing definitive corrective surgery. On the other hand, some studies have shown that one of the complications associated with halo traction could lead to cranial nerve palsy, with the sixth nerve (abducens nerve) being most commonly affected. To reduce the complications, gradual increases in the traction weight and detailed neurological examinations are needed, particularly for patients who have previously undergone brain or cervical surgery. The authors report a case of sixth cranial nerve palsy by preoperative halo-pelvic traction in patients with severe scoliosis who underwent previous decompression surgery for a Chiari I malformation with a review of the relevant literature.

Keyword

scoliosis; cranial nerve injury; abducens nerve injury; Arnold-Chiari malformation; halo-pelvic traction