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Thoracic disc herniation: An unusual complication after prone positioning in spinal surgery

Ameya S. Kamat MBBCh., Mohammed Zahier Ebrahim MBChB., Adriaan J. Vlok FC Neurosurg (SA)

Division of Neurosurgery, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa

Abstract

Neurological complications of the prone position have been well documented. Post-operative paraplegia and neurological deterioration unrelated to the site of surgery after proning in spinal surgery is a rare but potentially devastating complication. We describe the case of a 47 year old female who underwent an L4/5 discectomy and posterior instrumented fusion. A few hours after surgery she developed bilateral lower limb weakness with a T11 sensory level. Post-operative MRI revealed an acute disc herniation at the T11/12 level with associated spinal cord compression. This was not present on the pre-operative imaging. A subsequent T11/12 discectomy and instrumented fusion was performed and the patient's motor and sensory function returned to normal.

keywords: 
thoracic disc herniation, prone position, spinal surgery
Volume 10 Article 39
doi: 
10.14444/3039