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CARDIOVASCULAR ANESTHESIA

Tetraplegia After Coronary Artery Bypass Grafting

Susumu Fujioka, MD^*, Yoshinari Niimi, MD, Kazuo Hirata, MD^*, Itaru Nakamura, MD^*, and Shigeho Morita, MD

*Department of Anesthesia, Ageo Central General Hospital, Ageo, Saitama, Japan; and Department of Anesthesiology, School of Medicine, Teikyo University, Itabashi, Tokyo, Japan

Address correspondence and reprint requests to Susumu Fujioka, MD, Department of Anesthesia, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan. Address e-mail to susumu{at}db3.so-net.ne.jp

The authors present a rare case of a cervical cord dysfunction after uncomplicated coronary artery bypass grafting. The preoperative neurological examination did not reveal any abnormalities; however, the postoperative magnetic resonance image showed significant spinal canal stenosis at the same levels as high signal lesions. Although the pathophysiological basis of the case was impossible to determine retrospectively, it seems probable that placing the neck in an extended position during surgery might have aggravated a preexisting spinal canal stenosis to produce cervical injury.

IMPLICATIONS: The authors present a rare case of tetraplegia after coronary artery bypass grafting. It is suggested that neck extension during surgery might have aggravated an occult preexisting cervical spinal canal stenosis to produce cervical injury.

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