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European Spine Journal

, Volume 27, Supplement 3, pp 549–554 | Cite as

Bilateral vocal cord palsy after a posterior cervical laminoplasty

  • Chizuo Iwai
  • Kazunari Fushimi
  • Satoshi Nozawa
  • Yukihiro Shirai
  • Hiroyasu Ogawa
  • Ko Yasura
  • Katsuji Shimizu
  • Haruhiko Akiyama
Case Report

Abstract

Purpose

To report a patient with bilateral vocal cord palsy following cervical laminoplasty, who survived following a tracheotomy and intensive respiratory care.

Methods

Acute respiratory distress is a fatal complication of cervical spinal surgery. The incidence of bilateral vocal cord palsy after posterior cervical decompression surgery is extremely rare. The authors report a 71-year-old woman who suffered from cervical myelopathy due to ossification of the posterior longitudinal ligament. Open-door laminoplasty from C2 to C6 and laminectomy of C1 were performed. Following surgery, extubation was successfully conducted. Acute-onset dysphagia and stridor had occurred 2 h following extubation. A postoperative fiber optic laryngoscope revealed bilateral vocal cord palsy. After a tracheotomy and intensive respiratory care, she had completely recovered 2 months after surgery.

Discussion

One potential cause of this pathology was an intraoperative hyper-flexed neck position, which likely induced mechanical impingement of the larynx, resulting in swelling and edema of the vocal cords and recurrent laryngeal nerve paresis. Direct trauma of the vocal cords during intubation and extubation could have also induced vocal cord paralysis.

Conclusions

We reported a case of bilateral vocal cord palsy associated with posterior cervical laminoplasty. Airway complications following posterior spinal surgery are rare, but they do occur; therefore, spine surgeons should be aware of them and take necessary precautions against intraoperative neck position, intubation technique, even positioning of the intratracheal tube.

Keywords

Vocal cord palsy Surgery Respiratory distress Cervical laminoplasty Complication 

Notes

Acknowledgements

We would acknowledge people who have contributed to the study but do not fulfill all the criteria for authorship.

Funding

The authors received no financial and material support associated with this manuscript.

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryGifu University Graduate School of MedicineGifu CityJapan
  2. 2.Department of Orthopaedic Surgery, Spine CenterGifu Municipal HospitalGifuJapan

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