Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management

Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management

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 cervi...

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Main Authors: Sarah Merrill, Maziyar A. Kalani, Naresh P. Patel, Mark K. Lyons, Matthew T. Neal
Format: Article
Language:English
Published: Hindawi Limited 2020-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/8897071
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spelling doaj-8aefc80262f14ae392dffac817f693772020-11-25T03:54:58ZengHindawi LimitedCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/88970718897071Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical ManagementSarah Merrill0Maziyar A. Kalani1Naresh P. Patel2Mark K. Lyons3Matthew T. Neal4Mayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAMayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAMayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAMayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAMayo Clinic Arizona, Department of Neurological Surgery, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USACase 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.http://dx.doi.org/10.1155/2020/8897071
collection DOAJ
language English
format Article
sources DOAJ
author Sarah Merrill
Maziyar A. Kalani
Naresh P. Patel
Mark K. Lyons
Matthew T. Neal
spellingShingle Sarah Merrill
Maziyar A. Kalani
Naresh P. Patel
Mark K. Lyons
Matthew T. Neal
Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
Case Reports in Orthopedics
author_facet Sarah Merrill
Maziyar A. Kalani
Naresh P. Patel
Mark K. Lyons
Matthew T. Neal
author_sort Sarah Merrill
title Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
title_short Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
title_full Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
title_fullStr Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
title_full_unstemmed Acute Spinal Cord Contusion in a Patient with Multiple Upper Cervical Fractures, Parkinson’s Disease, and Torticollis: Surgical Management
title_sort acute spinal cord contusion in a patient with multiple upper cervical fractures, parkinson’s disease, and torticollis: surgical management
publisher Hindawi Limited
series Case Reports in Orthopedics
issn 2090-6749
2090-6757
publishDate 2020-01-01
description 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.
url http://dx.doi.org/10.1155/2020/8897071
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