Cervical Spinal Cord Ischemic Reperfusion Injury: A Comprehensive Narrative Review of the Literature and Case Presentation.

Autor:	Algahtani AY; King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.; King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, SAU., Bamsallm M; King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU., Alghamdi KT; King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU., Alzahrani M; Neurosurgery, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, SAU., Ahmed J; Neurosurgery Department, Aseer Central Hospital, Ministry of Health, Abha, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Sep 03; Vol. 14 (9), pp. e28715. Date of Electronic Publication: 2022 Sep 03 (Print Publication: 2022).
DOI:	10.7759/cureus.28715
Abstrakt:	Cervical spinal ischemic reperfusion injury (CSIRI) refers to a state of sudden neurological deterioration after surgical spinal decompression. The CSCIRI refers to a state of sudden neurological deterioration after surgical spinal decompression. The pathophysiology is hypothesized to be due to instant relief of a chronically compressed spinal cord, leading to an inflammatory cascade named ischemic reperfusion injury. Deterioration of neurological function after cervical spine decompression surgery often occurs secondary to direct cord injury, compressing hematoma, or hardware failure. Complete loss of neurological function with no organic explanation is an extremely rare complication, with only a few cases reported in the literature. We are reporting a 67-year-old male patient diagnosed with severe cervical spinal canal stenosis at level C5/6 who underwent anterior cervical discectomy and fusion (ACDF). The patient developed complete transient loss of neurological functions after the surgery and was labeled as a case of CSCIRI after excluding compressing pathology. A literature review of the CSCIRI was carried out, and ten articles were included. Due to the rarity of these cases, there is no class 1 or 2 evidence to establish management protocol nor identifiable risk factors to predict their occurrence. However, we recommend using an intra-operative neurophysiology monitor in cases with long-standing severe cervical canal stenosis with myelomalacia and managing these cases according to the acute spinal cord injury management protocol after excluding compressing pathologies. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Algahtani et al.)
Databáze:	MEDLINE
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