Thoracic Unilateral Spinal Cord Injury After Spinal Anaesthesia for Total Hip Replacement: Fate or Mistake?

Spinal anaesthesia is the most preffered anesthesia technique fortotal hip replacement, and its complications range from low entity(insignificant) to life threatening. The incidence of neurologiccomplications after neuraxial anaesthesia is not perfectly clear, althoughthere are several described cases of spinal cord ischaemia.We present a case of unilateral T8-T11 spinal cord ischaemia followingL2–L3 spinal anaesthesia for total hip replacement. Magneticresonance imaging showed a hyperintense T8–T11 signalalteration on the leftside of paramedian spinal cord. A temporalepidemiologic linkage between the damage and the surgery seemsto be present. The injury occurred without anatomical proximitybetween the injury site and the spinal needle entry site. This maybe due to multiple contributing factors, each of them is probablynot enough to determine the damage by itself; however, acting simultaneously,they could have been responsible for the complication.The result was unpredictable and unavoidable and was causedby unforeseeable circumstances and not by inadequate medical practice