Acute-onset paraplegia as an unexpected complication under general anesthesia in supine position during abdominal endovascular aneurysm repair: a case report

• Main Authors: Atsushi Morio, Hirotsugu Miyoshi, Noboru Saeki, Yukari Toyota, Yasuo M. Tsutsumi
• Format: Article
• Language: English
• Published: SpringerOpen 2021-06-01
• Series: JA Clinical Reports
• Subjects: Paraplegia; Spinal cord injury; Ischemic spinal cord injury; Endovascular aneurysm repair; Supine position
• Online Access: https://doi.org/10.1186/s40981-021-00447-7

Abstract Background Acute onset paraplegia after endovascular aneurysm repair (EVAR) is a rare but well-known complication. We here show a 79-year-old woman with paraplegia caused by static and dynamic spinal cord insult not by ischemia after EVAR. Case presentation The patient underwent EVAR for abdominal aortic aneurism under general anesthesia in the supine position. She had a medical history of lumbar canal stenosis. After the surgery, we recognized severe paraplegia and sensory disorder of lower limbs. Although the possibility of spinal cord ischemia was considered at that time, postoperative magnetic resonance imaging (MRI) revealed burst fracture of vertebra and compressed spinal cord. Conclusions Patients with spinal canal stenosis can cause extrinsic spinal cord injury even with weak external forces. Thus, even after EVAR, it is important to consider extrinsic factors as the cause of paraplegia.