A case report of pulmonary embolism following endoscopic cervical discectomy in an elderly patient with cervical disc herniation.
Shangchen Yu, Zheng Li, Shuguang Yang et al.
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Case in brief
A 65-year-old woman with cervical disc herniation, right arm pain, and multiple comorbidities underwent posterior percutaneous endoscopic cervical discectomy after conservative treatment failed. On postoperative day 2, dizziness and reduced oxygen saturation developed, followed by chest tightness the next day. Testing showed markedly elevated D-dimer; ultrasound identified thrombosis in the calf muscular veins of both legs, and CT pulmonary angiography confirmed multiple pulmonary emboli. With oxygen, monitoring, low-molecular-weight heparin anticoagulation, and supportive care in intensive care, her respiratory and circulatory status stabilized and symptoms resolved. She was discharged in stable condition.
What made this case unusual
Pulmonary emboli with bilateral calf muscular vein thrombosis occurred after a minimally invasive cervical discectomy, underscoring that limited surgical trauma does not preclude serious perioperative thromboembolism.
Diagnostic / clinical pearl
After spinal surgery, new hypoxemia, dizziness, or chest tightness warrants timely evaluation for venous thromboembolism, even after a minimally invasive procedure.