Gelatin Sponge-induced Early Onset Quadriparesis after the Posterior Decompression for Cervical Myelopathy Due to Ossification of a Posterior Longitudinal Ligament - A Case Report

BACKGROUND: Gelatin foam has been regularly used the complex neuro and spinal surgeries for a long time. Apart from their hemostatic properties, these are inert and provide form an inert membrane that prevents scar adhesions o vital structures such as the brain or spinal cord. CASE PRESENTATION: We present a case of cervical myelopathy due to an ossified posterior longitudinal ligament that underwent the instrumented posterior decompression and had neurological worsening 48 h after the index surgery. An magnetic resonance imaging showed a hematoma compressing the spinal cord which on exploration was confirmed to be a gelatin sponge. It represents the rare phenomenon of mass effect due to their osmotic properties, especially in a closed space causing neurologic deterioration. CONCLUSION: We emphasize the rare cause of early onset quadriparesis after the posterior decompression due to the swollen gelatin sponge over the neural elements. The patient recovered with timely intervention.