Dural Traction a Possible Cause of Hemodynamic Changes During Single-Level Transforaminal Lumbar Interbody Fusion

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• 作者：Jonathan M. Weimer¹ ; Martin Marinov² ; Rafi Avitsian³ ; ^{avitsir@ccf.org}
• 关键词：Asystole ; Dural traction ; Lumbar interbody fusion
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：761.e1-761.e3
• 全文大小：1038 K
• 卷排序：97

文摘

Lumbar spinal surgery may be associated with electrophysiologic and hemodynamic abnormalities during the procedure.Case DescriptionA 58-year-old man with grade II L4-5 spondylolisthesis and degenerative changes underwent single-level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on electrocardiogram and invasive hemodynamic monitoring. The events correlated with and possibly could have been a result of traction on the dura mater.ConclusionsAnesthesia providers should be aware of electrophysiologic and hemodynamic abnormalities during lumbar spinal surgery and the need to respond appropriately with sympathomimetic or vagolytic interventions.