The case of a 21-year-old woman without previous cervical pathology in
whom irreversible tetraplegia developed after operation for tracheal
stenosis is reported, After tracheal resection the neck was kept in ex
treme flexion and after extubation she was moved to a sitting position
. The different causal agents that could produce the neurologic damage
remain unclear, although we think that the combination of relative ar
terial hypotension secondary to the sitting position and disturbed aut
orregulation, caused by extreme neck flexion, could result in ischemic
spinal cord injury.