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Epidural Hematoma Causing Dense Paralysis After Anterior Cervical CorpectomyA Report of Two Cases
Joon Y. Lee, MD1; Daniel M. Schwartz, PhD, DABNM2; D. Greg Anderson, MD1; Alan S. Hilibrand, MD1
1 Department of Orthopaedic Surgery and The Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Avenue, 5th Floor, Philadelphia, PA 19107
2 Surgical Monitoring Associates, 25 Bala Avenue, Suite 105, Bala Cynwyd, PA 19004
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The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Jan 01;88(1):198-201. doi: 10.2106/JBJS.E.00313
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Paralysis after anterior cervical spine surgery is an uncommon, albeit devastating, complication. Flynn analyzed data from 36,657 anterior cervical interbody arthrodeses performed by 704 neurosurgeons and noted that only 100 patients (0.3%) had a permanent neurologic deficit1. Seventy-five percent of these patients exhibited symptoms of a neurologic deficit immediately on emergence from anesthesia, whereas 25% exhibited symptoms early in the postoperative recovery period. The most common causes of spinal cord injury during cervical spine surgery include surgical trauma, vascular compromise, graft impingement, instrument misplacement, and spinal manipulation.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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