Abstract
Paraplegia, a serious complication following spinal anaesthesia is associated with significant morbidity and even mortality. Though extremely rare, spinal anaesthesia has been shown to facilitate the manifestation of paraplegia secondary to spinal cord compression due to undiagnosed vertebral metastases. Similar presentation in a patient with a history of renal cell carcinoma is reported here where the patient had no neurological impairment preoperatively. Attention to preoperative neurological assessment in susceptible cases of spinal metastases is very important. DOI: http://dx.doi.org/10.4038/slja.v23i1.7797
Highlights
Case report A 55 year old male presented with painful bleeding per rectum of three months duration
MRI scan of thoracolumbar spine (Figure 2), which was performed within 12 hours after the admission, confirmed metastatic deposits on T12 vertebral body extending to left pedicle causing encroachment of spinal canal and cord compression
Neurological complications and it's sequelae following regional anaesthesia can be classified into three classes.[1]
Summary
R De S Kulasiri1, *T G Dissanayakege[2] Consultant Anaesthetist[1], National Hospital of Sri Lanka. Case report A 55 year old male presented with painful bleeding per rectum of three months duration He was diagnosed to have multiple chronic anal fissures and scheduled for lateral sphincterotomy under spinal anaesthesia. He did not reveal previous comorbid conditions involving major organ systems other than renal cell carcinoma, for which he had undergone left sided nephrectomy eight months ago. The positive neurological findings were; impaired muscle power of both knee joints (extension/flexion-Left KJ 4/4, Right KJ 4/5) and absent B/L knee jerk His bladder and bowel function was not affected. MRI scan of thoracolumbar spine (Figure 2), which was performed within 12 hours after the admission, confirmed metastatic deposits on T12 vertebral body extending to left pedicle causing encroachment of spinal canal and cord compression.
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