Potential risk of impertinent administration of methylprednisolone in lumbar spine surgery: A case report

INTRODUCTION: Several complications of intravenous administration of Methylprednisolone in spine surgery have been reported previously. However, perioperative Addisonian crisis resulting from postoperative routine cessation of intravenous Methylprednisolone has been rarely reported. We here report a case of perioperative Addisonian crisis induced by postoperative routine cessation of intravenous Methylprednisolone. PRESENTATION OF CASE: To report a 56-year-old lady was diagnosed with Addisonian crisis on postoperative duration of lumbar spine surgery after routine cessation of intravenous Methylprednisolone on postoperative day 5. DISCUSSION: There are potential risk and medical complexity of the intravenous administration of Methylprednisolone perioperatively when patients underwent spine surgery, especially the patients with a history of adrenal insufficiency or hypothyroidism, and other endocrine diseases. The early diagnosis and effective replacement therapy after cessation of intravenous glucocorticoid to keep normal serum hormone levels can reduce risk and complication of Addisonian crisis. CONCLUSION: Addisonian crisis may be triggered by the discontinuation of exogenous glucocorticoid. Physicians need to be immediately aware of this potentially lethal complication in patients with endocrine system diseases.