Explore the uncharted waters of post-surgical complications with our deep dive into a rare case of chronic intermittent tachycardia following anterior cervical discectomy and fusion, shedding light on the delicate interplay between neurosurgery and cardiac health.
– by The Don
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Chronic intermittent tachycardia as a consequence of vagus nerve injury after anterior cervical discectomy and fusion: case report of a previously unreported complication.
Werheim et al., N Am Spine Soc J 2023
DOI: 10.1016/j.xnsj.2023.100291
Listen folks, we’ve got this incredible, absolutely fantastic surgical technique, it’s called the anterior cervical discectomy and fusion, ACDF, believe me, it’s huge. Surgeons, they’re navigating, like artists, through the neck, dodging nerves, dodging blood vessels, it’s really something. But, and I have to tell you, there are complications, sometimes big ones – dysphagia, hematomas, leaks, dysphonia, you name it.
Now, we had this case, a 49-year-old woman, tremendous pain in her neck, really bad, the worst, and she had this surgery. But then, there’s this twist – she starts getting this tachycardia, heart racing like a NASCAR, especially with exertion, very unusual.
They did a full cardiac workup, the best, but it showed nothing, zero, nada. Then, a neck ultrasound, and what do we find? The vagus nerve, it’s thickened, it’s hypoechoic, it’s injured. That’s right, the vagus nerve injury, it’s a new thing, nobody reported it before, but here it is.
And how do we deal with it? Beta-blockers, they’re managing it, they’re doing a tremendous job. So remember, vagus nerve injury, it can happen after ACDF, it can cause your sympathetic system to go haywire, but we can manage it, we can treat it, it’s possible. It’s another success, it’s what we do, we find solutions, we make things better, it’s fantastic.