Acute postoperative bilateral vocal fold paralysis after posterior spinal correction for dropped head syndrome: A case report.

Abstract: Background Acute bilateral vocal fold paralysis is a life-threatening complication in spinal surgery but it is almost exclusively anticipated with anterior approaches. Bilateral vocal fold paralysis after posterior spinal surgery is exceedingly rare. Case Description We present a case of acute postoperative dyspnea due to vocal fold paralysis requiring intubation and surgical intervention after posterior spinal correction for the treatment of dropped head syndrome. The patient had a prior diagnosis of atypical Parkinson’s disease but has since been diagnosed as having multiple systems atrophy. Conclusions We suggest that multiple systems atrophy causes increased risk for bilateral vocal fold paralysis during surgical intervention of dropped head syndrome. This report might be of interest for those who perform spinal surgery in patients with neurological conditions.