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Fabio C, Romualdo DB, Eugenio AF, et al. Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?. Turk J Anaesthesiol Reanim. 2017;45(2):116-118doi: 10.5152/TJAR.2016.32967.
Fabio, C., Romualdo, D. B., Eugenio, A. F., Vittoradolfo, T., Massimiliano, V. A., & Giovanna, R. (2017). Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?. Turkish journal of anaesthesiology and reanimation, 45(2), 116-118. https://doi.org/10.5152/TJAR.2016.32967
Fabio, Costa, et al. "Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?." Turkish journal of anaesthesiology and reanimation vol. 45,2 (2017): 116-118. doi: https://doi.org/10.5152/TJAR.2016.32967
Fabio C, Romualdo DB, Eugenio AF, Vittoradolfo T, Massimiliano VA, Giovanna R. Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?. Turk J Anaesthesiol Reanim. 2017 Apr;45(2):116-118. doi: 10.5152/TJAR.2016.32967. Epub 2017 Jan 18. PMID: 28439446; PMCID: PMC5396897.
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Turk J Anaesthesiol Reanim. 2017 Apr;45(2):116-118. doi: 10.5152/TJAR.2016.32967. Epub 2017 Jan 18.

Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?.

Turkish journal of anaesthesiology and reanimation

Costa Fabio, Del Buono Romualdo, Agrò Felice Eugenio, Tambone Vittoradolfo, Vitali Andrea Massimiliano, Ricci Giovanna

Affiliations

  1. Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
  2. Commander of the Order of Merit of the Italian Republic, Full Professor of Anesthesia and Intensive Care, Chairman of Postgraduate School of Anaesthesia and Intensive Care, Director of the Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
  3. Institute of Philosophy of Scientific and Technological Practice, Università Campus Bio-Medico di Roma, Rome, Italy.
  4. Medical Direction of Campus Bio-Medico Hospital, Università Campus Bio-Medico di Roma, Rome, Italy.
  5. School of Law, Università di Camerino, Camerino, Italy.

PMID: 28439446 PMCID: PMC5396897 DOI: 10.5152/TJAR.2016.32967

Abstract

Spinal anaesthesia is the most preffered anesthesia technique for total hip replacement, and its complications range from low entity (insignificant) to life threatening. The incidence of neurologic complications after neuraxial anaesthesia is not perfectly clear, although there are several described cases of spinal cord ischaemia. We present a case of unilateral T8-T11 spinal cord ischaemia following L2-L3 spinal anaesthesia for total hip replacement. Magnetic resonance imaging showed a hyperintense T8-T11 signal alteration on the leftside of paramedian spinal cord. A temporal epidemiologic linkage between the damage and the surgery seems to be present. The injury occurred without anatomical proximity between the injury site and the spinal needle entry site. This may be due to multiple contributing factors, each of them is probably not enough to determine the damage by itself; however, acting simultaneously, they could have been responsible for the complication. The result was unpredictable and unavoidable and was caused by unforeseeable circumstances and not by inadequate medical practice.

Keywords: Spinal cord injuries; arthroplasty; hip replacement; ischaemic myelopathy; spinal anaesthesia; spinal cord ischaemia

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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