Bilateral vocal cord paralysis after anterior cervical discoidectomy and fusion in a case of whiplash cervical spine injury: A case report

BACKGROUND Bilateral vocal cord paralysis is a risk of anterior cervical discoidectomy and fusion. We discuss the mechanism of vocal cord paralysis and the preca utions necessary to avoid this catastrophic complication. A rare case of bi lateral vocal cord paralysis after anterior cervical discoidectomy and fusi on (ACD/F) is reported. CASE DESCRIPTION The patient, a 37-year-old male, was paraplegic, had bilateral intrinsic ha nd muscle weakness and sphincter involvement following a whiplash cervical spinal injury. A C5-C6 ACD/F for traumatic C5-C6 disc prolapse was performe d. On the third postoperative day, he developed difficulty in coughing and a husky voice. Otolaryngological evaluation revealed bilateral vocal cord p aralysis. He later required a tracheostomy that partially alleviated his ma jor symptoms. CONCLUSION In patients undergoing ACD/F, a mandatory preoperative evaluation of the vo cal cords should be performed. An appropriate modification in surgical plan ning should be made if vocal cord palsy is diagnosed preoperatively to prev ent bilateral vocal cord paralysis. Proper and judicious use of Cloward ret ractors is advocated. (C) 2000 by Elsevier Science Inc.