• François Dantas, Antônio Carlos Vieira Caires, Gustavo Agra Cariri, and Rolemberg DantasFernando LuizFLDepartment of Neurosurgery-Biocor Instituto, Nova Lima, Minas Gerais, Brazil; Pontifícia Universidade Católica de Minas Gerais-Belo Horizonte, Minas Gerais, Brazil. Electronic address: frdantas@uai.com.br..
• Department of Neurosurgery-Biocor Instituto, Nova Lima, Minas Gerais, Brazil; Faculdade de Ciências Médicas de Minas Gerais-Feluma Post-Graduation, Belo Horizonte, Minas Gerais, Brazil.
• World Neurosurg. 2021 Feb 1; 146: e175-e183.

BackgroundStroke is a potentially life-threatening condition that can lead to disability and prolonged hospital stay. Perioperative stroke is a rare complication of spine surgery, especially in elective procedures. The prevalence of this complication varies in the literature, and the physiopathology is uncertain in many cases. Our objective was to describe 5 cases of patients who underwent spine surgery complicated by perioperative stroke and to analyze their characteristics and clinical outcomes.MethodsWe retrospectively analyzed data from spine surgeries performed at a single institution from January 2016 to December 2019. Patients who presented with perioperative stroke were included. Data related to patient demographics, postoperative status, hospital stay, type of surgery, American Society of Anesthesiologists (ASA) score, neurologic status at discharge, and mortality were registered.ResultsFive of 1002 consecutive patients (0.49%) had complication of stroke during surgery. The surgeries included occipitocervical fusion, anterior cervical fusion, lumbar fusion, lumbosacral fusion, and thoracolumbar fusion. The mean age of patients was 52.2 ± 15.73 years (range, 39-78 years), and the mean time of hospitalization was 20 ± 26.93 days (range, 6-68 days). The majority of patients were women (80%). Three patients (60%) presented with ischemic stroke, and 2 patients (40%) had hemorrhagic stroke. Two patients were severely disabled, and 3 showed good neurologic outcomes; no in-hospital deaths were observed. The etiology of stroke remained uncertain in the majority of cases.ConclusionsDespite the rarity of this complication, perioperative stroke in spine surgery can lead to considerable morbidity. Precocious diagnosis and treatment may improve patient outcomes.Copyright © 2020 Elsevier Inc. All rights reserved.

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