Brown-Sequard syndrome caused by hyperextension in a patient with atlantoaxial subluxation due to an os odontoideum

Brown-Sequard syndrome is an uncommon complication of atlantoaxial arthrodesis. A 50-year-old fe-male visited our emergency department after falling from a ladder. Radiologic evaluations revealed chronic C1-2 instability with acute spinal cord injury. The day after atlantoaxial fusion was performed, she developed left-sided motor weakness and the loss of right-sided pain and temperature sensation. Based on physical examination and radiologic findings, we diagnosed her as having Brown-Sequard syndrome. Spine surgeons performing this procedure should therefore consider Brown-Sequard syn-drome if a patient displays signs of postoperative hemiplegia.

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11. Pollard ME, Apple DF. Factors associated with improved neurologic outcomes in patients with incomplete tetraplegia. Spine (Phila Pa 1976). 2003;28:33e39.

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9. Vilela MD, Jermani C, Braga BP. C1 lateral mass screws for posterior segmental stabilization of the upper cervical spine and a new method of three-point rigid fixation of the C1eC2 complex. Arq Neuropsiquiatr. 2006;64:762e767.

8. Bransford RJ, Freeborn MA, Russo AJ, et al. Accuracy and complications asso-ciated with posterior C1 screw fixation techniques: a radiographic and clinical assessment. Spine J. 2012;12:231e238.

7. Elliott RE, Tanweer O, Boah A, et al. Atlantoaxial fusion with screw-rod con-structs: meta-analysis and review of literature. World Neurosurg. 2014;81: 411e421.

6. Dumont TM, Stockwell DW, Horgan MA. Venous air embolism: an unusual complication of atlantoaxial arthrodesis: case report. Spine (Phila Pa 1976). 2010;35:E1238eE1240

5. Gallie WE. Skeletal traction in the treatment of fractures and dislocations of the cervical spine. Ann Surg. 1937;106:770e776.

4. Harms J, Melcher RP. Posterior C1eC2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976). 2001;26:2467e2471.

3. Aota Y, Honda A, Uesugi M, et al. Vertebral artery injury in C-1 lateral mass screw fixation. Case illustration. J Neurosurg Spine. 2006;5:554.

2. Huang DG, Hao DJ, Li GL, Guo H, Zhang YC, He BR. C2 nerve dysfunction associated with C1 lateral mass screw fixation. Orthop Surg. 2014;6:269e273.

1. Stovell MG, Pillay R. Subarachnoid hemorrhage and acute hydrocephalus as a complication of C1 lateral mass screws. Spine (Phila Pa 1976). 2013;38: E1162eE1165.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
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