This case involved an obese male patient with a multi-year history of lower leg pain and numbness. He eventually underwent decompression and fixation of the thoracic spine. After the procedure, he experienced pain relief but was unable to move his legs. A CT showed one of the pedicle screws to be somewhat medially positioned although not enough to cause paralysis. Still, a revision surgery was performed to correct the screw position. During surgery it was observed there was no impingement whatsoever of the thecal sac but the screw was re-positioned to a more lateral position. Unfortunately, the patient did not regain motor function.
The plaintiff alleged the misplaced pedicle screw damaged the spinal cord causing loss of motor function. The defense contended the plaintiff was neurologically compromised from his extensive multilevel disease and that he had actually been experiencing intermittent paralysis and cauda equina symptoms for many years. Further, during the hardware revision surgery, the surgeon visualized no impingement of the spinal cord at all. The medical team provided excellent care during this extremely difficult case, which was complicated by obesity and several co-morbidities. Unfortunately, failure to regain motor function is not an unexpected outcome for a patient with a history of years of severe spinal stenosis.