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Mortality and Morbidity Associated With Correction of Severe Cervical Hyperextension

Poulter, Gregory T. MD*; Garton, Hugh J. L. MD†; Blakemore, Laurel C. MD‡; Hensinger, Robert N. MD§; Graziano, Gregory P. MD§; Farley, Frances A. MD§

Spine:
doi: 10.1097/BRS.0b013e3181947ce4
Cervical Spine
Abstract

Study Design. Three case reports of patients with treatment of severe cervical hyperextension.

Objective. Cervical hyperextension is a rare spine deformity that is associated with myopathies. Previous reports of surgical correction have reported no major operative complications. This report outlines our experience with 3 patients who experienced significant complications.

Summary of Background Data. The limited literature on the treatment of cervical hyperextension has good to excellent outcomes.

Methods. Three case reports are presented.

Results. Three cases with severe cervical hyperextension with intraoperative correction had associated morbidity and mortality. One case had a failed intubation requiring tracheotomy. This was followed by a successful posterior release with halo traction for 2 weeks and then an instrumented posterior cervical fusion. This patient died at home 2 weeks after surgery. The second and third cases had an intraoperative spinal cord injury during a posterior release for cervical hyperextension.

Conclusion. Patients with severe cervical hyperextension have high neurologic perioperative risk.

In Brief

Three cases with severe cervical hyperextension with intraoperative correction had associated morbidity and mortality. Patients with severe cervical hyperextension have high neurological perioperative risk.

Author Information

From the *Department of Orthopedic Surgery, University of California, SanFrancisco, CA; †Department of Neurosurgery, University of Michigan, Ann Arbor, MI; ‡Department of Surgery, Children’s National Medical Center, Washington, DC; and §Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI.

Acknowledgment date: March 25, 2008. First revision date: July 28, 2008. Second revision date: September 17, 2008. Acceptance date: September 23, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprints requests to Frances A. Farley, MD, TC2918B, University of Michigan Hospitals, 1500 East Medical Dr, Ann Arbor, MI, 48109; E-mail: fafarley@umich.edu

© 2009 Lippincott Williams & Wilkins, Inc.