Rhabdomyolysis as a Postoperative Complication of Multilevel Soft-tissue Surgery in a Child With Cerebral Palsy

Rhabdomyolysis is a potentially life-threatening syndrome if unrecognized. The most common causes are trauma, excessive muscle activity, alcohol abuse, and toxic substances. Rhabdomyolysis as a postoperative complication in children with cerebral palsy who have received multilevel soft-tissue surgery has not been reported in the literature. The purposes of this study are to present the case of a 12-year-old boy with spastic quadriplegic cerebral palsy who developed rhabdomyolysis after soft-tissue release and to review the literature. The patient was treated with adequate sedation and hydration, and discharged in a stable condition 11 days after surgery. His serum creatine kinase level had returned to within the normal range by the 17th postoperative day. At the 6-month follow-up, there were no systemic sequelae. The prompt recognition of rhabdomyolysis depends on a high level of suspicion. Routine checks of urine color after surgery is mandatory. For patients with high muscle tone, monitoring of muscle enzymes is recommended. Adequate sedation, pain control and hydration may prevent the progression of this life-threatening condition.