Liver and skeletal muscle injury in a 12-year-old female patient after scoliosis correction in prone position: a case report

Spine Deform. 2020 Apr;8(2):345-348. doi: 10.1007/s43390-019-00011-5. Epub 2020 Jan 8.

Abstract

We report the case of a 12-year-old female, otherwise healthy patient, who underwent surgery for scoliosis correction in prone position under total intravenous general anesthesia, with CardioQ and sensory-motor-evoked potentials for hemodynamic and neurological monitoring. The patient showed severe intraoperative hypotension, lactic acidosis, and complete abolition of motor-evoked potentials during the positioning of posterior corrective bars. During the postoperative period, the increase in muscle and liver enzymes indicated an abdominal organ damage and confirmed hypoperfusion of the lower limbs. Both side effects were caused by the malposition of the patient on the operating table. The case resolved within the first postoperative week without sequelae.

Keywords: Intraoperative complications; Liver; Prone position; Scoliosis.

Publication types

  • Case Reports

MeSH terms

  • Acidosis / diagnosis
  • Acidosis / etiology
  • Child
  • Evoked Potentials, Motor
  • Female
  • Humans
  • Hypotension / diagnosis
  • Hypotension / etiology
  • Iatrogenic Disease
  • Intraoperative Complications / diagnosis*
  • Intraoperative Complications / etiology*
  • Intraoperative Neurophysiological Monitoring
  • Lactic Acid
  • Liver / injuries*
  • Muscle, Skeletal / injuries*
  • Patient Positioning / adverse effects*
  • Prone Position*
  • Scoliosis / surgery*
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / methods

Substances

  • Lactic Acid