A 12-year-old girl with osteogenesis imperfecta (OI) underwent posterior spinal arthrodesis (from T2 to the sacrum) for double major-curve scoliosis. She developed complete paralysis of all of the extremities 24 hours after surgery, without evidence of ischemia or infarction. The rods were removed, and the neurologic status improved; there was full restoration of strength within 1 week. She then underwent in situ fixation. At the 2-year follow-up, there had been no lapse in neurologic function.
Reversible, distraction-induced neurologic deficits can occur outside of the instrumented spinal segment after corrective scoliosis surgery, particularly in patients with ligamentous laxity, as seen with OI.
1Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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