Blood pressure cuff-induced radial nerve palsy following minimally invasive lateral microdiscectomy: illustrative case.

Autor:	Rifi Z; 1David Geffen School of Medicine and.; 4Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California., Thum JA; 2Department of Neurosurgery, University of California, San Francisco, San Francisco, California; and., Sten MS; 3Georgetown University School of Medicine, Georgetown University, Washington, DC., Florence TJ; 4Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California., Dorsi MJ; 4Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Nov 13; Vol. 6 (20). Date of Electronic Publication: 2023 Nov 13 (Print Publication: 2023).
DOI:	10.3171/CASE23468
Abstrakt:	Background: The authors describe a rare case of transient postoperative wrist and finger drop following a prone position minimally invasive surgery (MIS) lateral microdiscectomy. Observations: Hand and wrist drop is an unusual complication following spine surgery, especially in prone positioning. The authors' multidisciplinary team assessed a patient with this complication following MIS lateral microdiscectomy. The broad differential diagnosis included radial nerve palsy, C7 radiculopathy, stroke, and spinal cord injury. Given the patient's supinator weakness, intact pronation and wrist flexion, and transient recovery within 4 weeks, the most likely diagnosis was radial nerve neuropraxia secondary to ischemic compression. After careful consideration of the operative environment and anatomical constraints, the patient's blood pressure cuff was found to be the most probable source of compression. Lessons: Blood pressure cuff-induced peripheral nerve injury may be a source of postoperative radial nerve neuropraxia in patients undergoing spine surgery. Careful considerations must be given to the blood pressure cuff location, which should not be placed at the distal end of the humerus due to higher susceptibility of peripheral nerve compression. Spine surgeons should be aware of and appropriately localize postoperative deficits along the neuroaxis, including central versus proximal or distal peripheral injuries, in order to guide appropriate postoperative management.
Databáze:	MEDLINE
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