Complete spinal cord injury from postoperative seroma following scoliosis surgery: A case report with favorable ambulatory outcomes after comprehensive rehabilitation

摘要

CONTEXT: Postoperative seroma is a known complication following spine deformity surgery. However, complete spinal cord injury (SCI) due to postoperative seroma is rare. Rehabilitation strategies and outcomes of SCI associated with postoperative seroma have been inadequately described. FINDINGS: A 15-year-old female experienced inadvertent durotomy during pinal deformity correction surgery for idiopathic adolescent scoliosis. Despite immediate decompressive laminectomy, she developed complete loss of motor and sensory function with neurological level of injury at T10 immediately following the surgery. Urgent magnetic resonance imaging revealed cord compression due to seroma. Decompressive surgery was performed 48 h later and timely intensive rehabilitation was provided for 3 months, which included the use of robotic-assisted gait training (RAGT) to maximize neurological recovery. She demonstrated impressive improvement from grade A to D on the American Spinal Injury Association Impairment Scale and regained functional ambulation over the 3-month period. We describe a comprehensive rehabilitation program to manage SCI associated with postoperative seroma, entailing the use of a robotic gait device for locomotor training. The progression of the patient's neurological status and functional outcomes was documented accordingly. CONCLUSION/CLINICAL RELEVANCE: Complete SCI due to seroma, a surgical complication of corrective scoliosis surgery, is rare. However, prompt postoperative examination should be performed routinely in anticipation of neurological deterioration. Early rehabilitation comprising of gait re-training and the use of RAGT might enhance the lower-limb motor strength and functional recovery.