脊椎ジャーナル

Life-Threatening Upper Airway Obstruction as a Complication of Corrective Spinal Surgery in a Patient with Parkinson's Disease: A Case Report

Abstract

Takashi Kobayashi, Naohisa Miyakoshi, Toshiki Abe, Kazuma Kikuchi, Eiji Abe, Kaori Fujiwara and Yoichi Shimada

A 74-year-old female with a 10-year history of Parkinson’s disease visited our hospital complaining of severe kyphoscoliosis deformity. Corrective spinal surgery was performed through a posterior approach. Oral anti-Parkinson medication was continued until the day of surgery, when continuous intravenous dopamine infusion was initiated; dopamine was discontinued and oral medication restarted on the day after surgery. Four weeks after surgery, the patient developed dyspnea. Laryngeal examination revealed rigidity of the neck muscles causing upper airway obstruction. Emergency tracheotomy was performed and the patient’s respiratory condition improved immediately. Because of difficulty of swallowing, gastrostomy was performed 2 weeks after tracheotomy. After tracheotomy and gastrostomy, the patient’s respiratory condition improved. Life-threatening upper airway obstruction can occur after corrective spine surgery in patients with Parkinson’s disease. It is important to ensure the oral administration of anti- Parkinson medication after surgery.