Case Study: Locked-In Syndrome After Elective Cervical Foraminotomy

Spine Injury

A 54-year-old male, who previously battled head and neck cancer, suffered a rare instance of locked-in syndrome subsequent to cervical spinal surgery prompted by a vehicle accident in the vicinity of his prior surgical sites.

Following a car accident that exacerbated neck pain, the patient, with a history of prior successful anterior cervical discectomy and fusion, underwent a cervical posterior foraminotomy from C4-C7. The surgery, which took place without incident, aimed to address the patient’s chronic pain. However, on the first day after the procedure, he experienced a sudden and severe decline in his physical abilities, leading to an inability to speak or move his extremities.

Medical imaging, including CT angiography and near-infrared spectroscopy, revealed that the patient had suffered a basilar artery occlusion and dissection of the left vertebral artery. Further examination with MRI determined that there were infarcts in critical areas of the brain, including the bilateral pons, left cerebral hemisphere, and left cerebellum—a direct cause of the patient’s locked-in condition, which is characterized by full paralysis except for eye movements.

Source: Nature.com

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