Brachial plexus injury following CVC insertion
Abstract:
Introduction: Internal Jugular Venous (IJV) cannulation or central-line insertion is frequently performed during kyphoscoliosis deformity correction surgery or spine surgery with high risk. This helps monitor central venous pressure and administer medicines when required. Although many complications of IJV cannulation have been reported in the literature, its effect on brachial plexus is not known. The objective of this paper was to report a rare complication of IJV during scoliosis surgery.
Case presentation: We reported a case of 27-year-old male who was operated for severe kyphoscoliosis correction where preoperatively IJV cannulation was done. Repeated attempts were done during IJV cannula insertion due to altered anatomy. Eventually, cannula insertion was done using ultrasound modality and surgery for correction was done. Postoperatively patient developed right upper extremity weakness and sensory loss although the clinical result of kyphoscoliosis correction was acceptable. EMG-NCV study proved it brachial plexus injury. The patient was treated with intravenous steroid and physiotherapy. The patient recovered completely within 6 months of surgery.
Conclusion: We reported a case of kyphoscoliosis deformity corrective surgery where IJV cannulation led to brachial plexus injury and was eventually recovered with medications and physiotherapy.
Reference:
Modi HN, Goel SA, Sharma A, Patel U. Brachial Plexus Injury due to Central-line Insertion during Kypho-scoliosis Deformity Correction. J Orthop Case Rep. 2021 Jul;11(7):41-44. doi: 10.13107/jocr.2021.v11.i07.2308. PMID: 34790601; PMCID: PMC8576778.