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Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report
BACKGROUND: Back pain is common in the gravid population and spinal cord infarction (SCI) or chronic osteomyelitis are exceptionally rare underlying causes of back pain in this population. No case report to date has described this unexpected adverse event in a gravid woman with suspected history of...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9730552/ https://www.ncbi.nlm.nih.gov/pubmed/36476140 http://dx.doi.org/10.1186/s12884-022-05157-1 |
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author | Baldino, Janine N. Recknagel, Johnathon Beckham, A. Jenna |
author_facet | Baldino, Janine N. Recknagel, Johnathon Beckham, A. Jenna |
author_sort | Baldino, Janine N. |
collection | PubMed |
description | BACKGROUND: Back pain is common in the gravid population and spinal cord infarction (SCI) or chronic osteomyelitis are exceptionally rare underlying causes of back pain in this population. No case report to date has described this unexpected adverse event in a gravid woman with suspected history of IV drug use (IVDU). This diagnosis could potentially become more common with increasing rates of IVDU, and increased education could result in sooner recognition. CASE: A 38 year old G9P0171 at 24 weeks gestation with a complex past medical history, and a suspected history of IVDU, presented repeatedly with back pain. Following cesarean delivery at 36w2d, she developed signs and symptoms of an anterior spinal artery syndrome (ASAS) and had evidence of chronic osteomyelitis at T9-T10 on imaging. This required emergent decompressive laminectomy and ultimately resulted in paraplegia. CONCLUSION: This case highlights the difficulties in recognizing all SCI risk factors pre-operatively and the importance of investigating back pain in pregnant patients with a suspected history of IVDU. We believe this patient’s chronic infection put her at an increased risk for SCI that was possibly compounded by the anatomical changes from its chronicity, possibly occurring in combination with several other precipitating causes of hypoperfusion. We hope this case report highlights the modern necessity to include a history, or suspected history, of IVDU as a red flag to initiate imaging in pregnant patients with acute, persistent, or unresolved back pain. |
format | Online Article Text |
id | pubmed-9730552 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97305522022-12-09 Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report Baldino, Janine N. Recknagel, Johnathon Beckham, A. Jenna BMC Pregnancy Childbirth Case Report BACKGROUND: Back pain is common in the gravid population and spinal cord infarction (SCI) or chronic osteomyelitis are exceptionally rare underlying causes of back pain in this population. No case report to date has described this unexpected adverse event in a gravid woman with suspected history of IV drug use (IVDU). This diagnosis could potentially become more common with increasing rates of IVDU, and increased education could result in sooner recognition. CASE: A 38 year old G9P0171 at 24 weeks gestation with a complex past medical history, and a suspected history of IVDU, presented repeatedly with back pain. Following cesarean delivery at 36w2d, she developed signs and symptoms of an anterior spinal artery syndrome (ASAS) and had evidence of chronic osteomyelitis at T9-T10 on imaging. This required emergent decompressive laminectomy and ultimately resulted in paraplegia. CONCLUSION: This case highlights the difficulties in recognizing all SCI risk factors pre-operatively and the importance of investigating back pain in pregnant patients with a suspected history of IVDU. We believe this patient’s chronic infection put her at an increased risk for SCI that was possibly compounded by the anatomical changes from its chronicity, possibly occurring in combination with several other precipitating causes of hypoperfusion. We hope this case report highlights the modern necessity to include a history, or suspected history, of IVDU as a red flag to initiate imaging in pregnant patients with acute, persistent, or unresolved back pain. BioMed Central 2022-12-07 /pmc/articles/PMC9730552/ /pubmed/36476140 http://dx.doi.org/10.1186/s12884-022-05157-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Baldino, Janine N. Recknagel, Johnathon Beckham, A. Jenna Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title | Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title_full | Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title_fullStr | Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title_full_unstemmed | Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title_short | Postoperative spinal cord infarction on a gravid woman with suspected IV drug use: a case report |
title_sort | postoperative spinal cord infarction on a gravid woman with suspected iv drug use: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9730552/ https://www.ncbi.nlm.nih.gov/pubmed/36476140 http://dx.doi.org/10.1186/s12884-022-05157-1 |
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