Posterior reversible encephalopathy syndrome following spine surgery: A case report and review of the literature

Abstract

Posterior reversible encephalopathy syndrome (PRES) following spine surgery was first documented in 2011. Reports have been rare, and sufficient consensus has not been established for clinical application. We presented a case of PRES following spine surgery. The patient was a 35-year-old woman with a history of hypertension who successfully received microendoscopic L5-S1 lumbar discectomy for lumbar disc herniation at L5-S1 under general anesthesia. Six hours after surgery, she suffered from headache, nausea, visual disturbance, and seizures. Magnetic resonance imaging revealed vasogenic edema in the occipital lobe, and she was diagnosed with PRES. Prompt symptomatic treatment resulted in a full recovery at 3 days after surgery. Subsequently, we reviewed the literature pertaining to PRES following spine surgery. The review of the relevant literature on PRES following spine surgery identified 12 cases (male, n = 2; female, n = 10; average age, 59.5 years). Approximately 92% patients received multi-level decompressive laminectomy and/or fusion. This case and the review of the relevant literature suggest that even minimally invasive spine surgery in a young woman with specific characteristics (eg, hypertension) can cause PRES.