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Epidural Hematoma Causing Dense Paralysis After Anterior Cervical CorpectomyA Report of Two Cases
Joon Y. Lee, MD1; Daniel M. Schwartz, PhD, DABNM2; D. Greg Anderson, MD1; Alan S. Hilibrand, MD1
1 Department of Orthopaedic Surgery and The Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Avenue, 5th Floor, Philadelphia, PA 19107
2 Surgical Monitoring Associates, 25 Bala Avenue, Suite 105, Bala Cynwyd, PA 19004
The Journal of Bone & Joint Surgery.  2006; 88:198-201  doi:10.2106/JBJS.E.00313
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Extract

Paralysis after anterior cervical spine surgery is an uncommon, albeit devastating, complication. Flynn analyzed data from 36,657 anterior cervical interbody arthrodeses performed by 704 neurosurgeons and noted that only 100 patients (0.3%) had a permanent neurologic deficit1. Seventy-five percent of these patients exhibited symptoms of a neurologic deficit immediately on emergence from anesthesia, whereas 25% exhibited symptoms early in the postoperative recovery period. The most common causes of spinal cord injury during cervical spine surgery include surgical trauma, vascular compromise, graft impingement, instrument misplacement, and spinal manipulation.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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