Our Summary

This research paper discusses a rare case where a woman developed paralysis in both legs after a lung surgery, not related to the aorta. The 56-year-old patient was suffering from severe shortness of breath due to a tumor in her chest area. After the tumor was removed, she experienced bleeding near her spine which was stopped using a special medical gauze. However, the gauze, combined with blood clots, ended up compressing her spinal cord, leading to paralysis from the mid-torso down. Despite efforts to remove the gauze and blood clots and provide intensive physical therapy, her condition did not improve. The study emphasizes the need for surgeons to be aware of possible complications when working near the spine, even when using normally helpful tools like hemostatic agents.

FAQs

  1. What caused the paralysis in the 56-year-old woman’s legs after her lung surgery?
  2. What efforts were made to improve the woman’s condition after the surgery?
  3. What is the study’s main recommendation for surgeons working near the spine?

Doctor’s Tip

A doctor might tell a patient undergoing spinal laminectomy that it is important to follow post-operative care instructions carefully, including proper wound care, physical therapy, and avoiding heavy lifting or strenuous activities. It is also important to report any unusual symptoms or complications, such as increasing pain, numbness, weakness, or changes in bowel or bladder function, to your healthcare provider immediately. This can help prevent potential complications and promote a successful recovery.

Suitable For

Spinal laminectomy is typically recommended for patients who are suffering from conditions that cause compression of the spinal cord or nerve roots in the spine. Some common conditions that may require a spinal laminectomy include:

  1. Spinal stenosis: This is a condition where the spinal canal narrows, putting pressure on the spinal cord and nerves. Spinal laminectomy may be recommended to relieve this pressure and alleviate symptoms such as pain, numbness, and weakness in the legs.

  2. Herniated disc: A herniated disc occurs when the soft inner core of a disc in the spine bulges out and puts pressure on nearby nerves. Spinal laminectomy may be performed to remove the herniated portion of the disc and relieve nerve compression.

  3. Spinal tumors: Tumors in the spine can cause compression of the spinal cord and nerves, leading to symptoms such as pain, weakness, and numbness. Spinal laminectomy may be recommended to remove the tumor and decompress the spinal cord.

  4. Traumatic spinal cord injury: In cases of traumatic spinal cord injury, where the spinal cord is damaged due to a sudden blow or impact, spinal laminectomy may be performed to remove fragments of bone or tissue that are compressing the spinal cord.

  5. Degenerative disc disease: This is a condition where the discs in the spine degenerate over time, leading to symptoms such as pain and stiffness. Spinal laminectomy may be recommended to remove damaged portions of the disc and relieve pressure on the spinal cord and nerves.

Overall, spinal laminectomy is a surgical procedure that is typically recommended for patients with severe symptoms of spinal cord or nerve compression that have not improved with conservative treatments such as medication or physical therapy. It is important for patients to discuss the risks and benefits of spinal laminectomy with their healthcare provider to determine if it is the right treatment option for their specific condition.

Timeline

Before spinal laminectomy:

  1. Patient experiences severe shortness of breath due to a tumor in her chest area.
  2. Lung surgery is performed to remove the tumor.
  3. Bleeding near the spine occurs during surgery and is stopped using medical gauze.
  4. Gauze and blood clots compress the spinal cord, leading to paralysis from the mid-torso down.

After spinal laminectomy:

  1. Efforts are made to remove the gauze and blood clots from the spinal cord.
  2. Intensive physical therapy is provided to the patient.
  3. Despite treatment, the patient’s paralysis does not improve.
  4. The study highlights the importance of surgeons being aware of potential complications when operating near the spine.

What to Ask Your Doctor

  1. What is a spinal laminectomy and why is it being recommended for me?
  2. What are the risks and potential complications associated with a spinal laminectomy?
  3. What is the success rate of this procedure in relieving my specific symptoms?
  4. What is the expected recovery time and rehabilitation process after a spinal laminectomy?
  5. Are there any alternative treatment options available for my condition?
  6. Will I need any additional follow-up appointments or procedures after the spinal laminectomy?
  7. How experienced are you in performing spinal laminectomies and what is your success rate?
  8. What steps will be taken to minimize the risk of complications during the surgery?
  9. What can I do to prepare for the spinal laminectomy and optimize my chances of a successful outcome?
  10. What symptoms should I watch for after the procedure that may indicate a complication or need for further medical attention?

Reference

Authors: Than DJ, Perumall VV, Johan S, Lee XL, Karim KA, Hayati F. Journal: Einstein (Sao Paulo). 2023 Jul 10;21:eRC0078. doi: 10.31744/einstein_journal/2023RC0078. eCollection 2023. PMID: 37436267