Eur Spine J, 2009 · DOI: 10.1007/s00586-009-0944-6 · Published: March 28, 2009
Bradycardia and cardiac arrest can occur after cervical spine injuries due to reduced sympathetic activity, usually resolving within 4-6 weeks. This case reports a rare instance where a patient with a cervico-dorsal spinal injury required a permanent pacemaker due to persistent cardiac arrest. A 47-year-old male with a traumatic C7–D1 dislocation experienced severe bradycardia and multiple cardiac arrests for two months post-injury, necessitating a permanent pacemaker. Following pacemaker implantation, cardiac arrests ceased, and the patient was successfully rehabilitated. This case highlights the rare complication of cardiac arrest in cervico-dorsal injuries, emphasizing the importance of permanent pacemakers for patient safety when other causes are ruled out.
Clinicians should be aware of the possibility of persistent cardiac instability requiring permanent pacing even in lower cervical-dorsal spinal injuries.
When managing bradycardia and cardiac arrest following spinal cord injury, especially in cervico-dorsal injuries, consider cardiac sympathetic denervation as a potential etiology after excluding other common causes.
Permanent cardiac pacing can be a life-saving intervention for patients with cervico-dorsal spinal injuries who experience persistent cardiac instability despite conventional management.