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Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report

INTRODUCTION AND IMPORTANCE: The trend in cycling nowadays affects all age groups. However, special precautions must be considered in the elderly group. Minor trauma to the cervical region can cause severe neurological deterioration, leading to fatality because of the pre-existing degenerative proce...

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Autores principales: Saleh, Ifran, Librianto, Didik, Kamal, Achmad Fauzi, Ipang, Fachrisal, Widodo, Wahyu, Aprilya, Dina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9198316/
https://www.ncbi.nlm.nih.gov/pubmed/35704987
http://dx.doi.org/10.1016/j.ijscr.2022.107285
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author Saleh, Ifran
Librianto, Didik
Kamal, Achmad Fauzi
Ipang, Fachrisal
Widodo, Wahyu
Aprilya, Dina
author_facet Saleh, Ifran
Librianto, Didik
Kamal, Achmad Fauzi
Ipang, Fachrisal
Widodo, Wahyu
Aprilya, Dina
author_sort Saleh, Ifran
collection PubMed
description INTRODUCTION AND IMPORTANCE: The trend in cycling nowadays affects all age groups. However, special precautions must be considered in the elderly group. Minor trauma to the cervical region can cause severe neurological deterioration, leading to fatality because of the pre-existing degenerative process. CASE PRESENTATION: We present a case of a 61-year-old male recreational cyclist with acute onset of tetraplegia following a minor fall. The radiological result revealed a long-standing degenerative process. Unfortunately, the patient deceased due to the sequelae of the paralysis and cardiac event despite our prompt surgical decompression and the improvement shown on intraoperative neuromonitoring. CLINICAL DISCUSSION: The degenerative process can aggravate cervical cord injury even in its mildest form of injury. In this study, immediate improvement was detected by the intraoperative neuromonitoring (IONM) - although the clinical improvement had not improved yet as the general condition is poor. CONCLUSION: The elder cycling population is increasing. Safety measures and injury avoidance are advisable along with expert consultation before the exercise. In a pre-existing degenerative condition of the cervical, a special precaution is also needed during the exercise. If the surgery has been indicated, the use of intraoperative neuromonitoring is found to be useful to guide the decompression and potentially beneficial as a predictive value for the clinal outcome.
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spelling pubmed-91983162022-06-16 Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report Saleh, Ifran Librianto, Didik Kamal, Achmad Fauzi Ipang, Fachrisal Widodo, Wahyu Aprilya, Dina Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: The trend in cycling nowadays affects all age groups. However, special precautions must be considered in the elderly group. Minor trauma to the cervical region can cause severe neurological deterioration, leading to fatality because of the pre-existing degenerative process. CASE PRESENTATION: We present a case of a 61-year-old male recreational cyclist with acute onset of tetraplegia following a minor fall. The radiological result revealed a long-standing degenerative process. Unfortunately, the patient deceased due to the sequelae of the paralysis and cardiac event despite our prompt surgical decompression and the improvement shown on intraoperative neuromonitoring. CLINICAL DISCUSSION: The degenerative process can aggravate cervical cord injury even in its mildest form of injury. In this study, immediate improvement was detected by the intraoperative neuromonitoring (IONM) - although the clinical improvement had not improved yet as the general condition is poor. CONCLUSION: The elder cycling population is increasing. Safety measures and injury avoidance are advisable along with expert consultation before the exercise. In a pre-existing degenerative condition of the cervical, a special precaution is also needed during the exercise. If the surgery has been indicated, the use of intraoperative neuromonitoring is found to be useful to guide the decompression and potentially beneficial as a predictive value for the clinal outcome. Elsevier 2022-06-07 /pmc/articles/PMC9198316/ /pubmed/35704987 http://dx.doi.org/10.1016/j.ijscr.2022.107285 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Saleh, Ifran
Librianto, Didik
Kamal, Achmad Fauzi
Ipang, Fachrisal
Widodo, Wahyu
Aprilya, Dina
Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title_full Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title_fullStr Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title_full_unstemmed Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title_short Particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: A case report
title_sort particular precautions and the role of intraoperative neuromonitoring in cervical cord injury in elder recreational cyclist: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9198316/
https://www.ncbi.nlm.nih.gov/pubmed/35704987
http://dx.doi.org/10.1016/j.ijscr.2022.107285
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