Tetraplegia After Thyroidectomy in a Patient with Cervical Spondylosis
Bibliographic record
Abstract
Cervical spondylosis is degeneration of the cervical spine that occurs during the normal course of aging, and may progress into compression of the spinal cord, or cervical spondylotic myelopathy (CSM), which can cause neurologic dysfunction. Cervical spondylosis can be identified in the majority of people older than 50 years. Many people with cervical spondylosis or CSM are asymptomatic. However, patients with CSM are at higher risk of spinal cord injury (SCI) following minor injury.A 60-year-old woman with asymptomatic cervical spondylosis underwent an elective subtotal thyroidectomy for thyroid nodules. After the surgery, she developed tetraplegia. MRI revealed spinal cord compression and injury. Main diagnoses, therapeutics interventions, and outcomes: Acute cervical SCI was diagnosed. After an emergency anterior cervical corpectomy and fusion surgery, she almost completely recovered.Iatrogenic cervical SCI after nonspinal surgeries that requires neck hyperextension is rarely reported, probably due to underdiagnosis and underreport. Among the 14 cases (including ours) published in the literature, most patients had cervical spondylosis and were senior men. Five patients had diabetes. Four patients had long-term hemodialysis. Seven patients had undergone coronary artery bypass surgery that requires prolonged operative time. Only 3 patients had almost complete recovery. Most patients were disabled. Two patients required tracheostomy for long-term ventilator support. Two patients died. These cases reiterate the potential risk of iatrogenic SCI in people with predisposing conditions such as cervical spondylosis, especially considering the rising prevalence and severity of cervical spondylosis caused by the aging of the population and modern sedentary lifestyle. Surgeries requiring prolonged neck hyperextension put patients with cervical spondylosis at risk for SCI. Failure to recognize the potential occurrence of iatrogenic SCI might endanger patients' lives.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".