Disclosures: Joshua M. Schatzman, MD: Nothing to disclose

Case Description: Patient underwent fluoroscopic guided palliative cryoablation at 50-60% power for 8 minutes within 1 cm of posterior cortex and kyphoplasty for increased back pain due to T6 compression fracture. Immediately following procedure, patient developed right lower extremity paralysis with full sensation and no pain. Physicians suspected hypothermic damage to spinal cord and patient was started on IV steroids. Post-operative day 1 patient developed neurogenic bowel and bladder. MRI same day of procedure demonstrated right lateral cord edema at T5-T6. Post-operative day 8 patient was admitted to our rehab facility where ASIA exam confirmed right lower extremity weakness and additionally bilateral loss of pin prick sensation starting at T7 dermatome. Patient was incontinent with bowel and bladder managed by indwelling catheter. Patient was diagnosed with T6 ASIA D with right partial Brown-Sequard syndrome.

Setting: Acute Care Hospital/Inpatient Rehabilitation Facility

Patient: 57-year-old male with metastatic renal cell carcinoma to thoracic spine.

Assessment/Results: Patient had repeat ASIA exam performed during IRF stay which showed return of pin prick sensation on right side with impaired pin prick on left side. Patient received education on bladder and bowel program but needed supervision for ADLs and minimum assistance for transfers. Patient unable to walk due to significant weakness and pain in his leg requiring use of wheelchair for ambulation.

Discussion: This is the second reported case, to our knowledge, of spinal cord injury following cryoablation of compression fracture. Patient underwent procedure to improve quality of life but complications led to significant disability. Post procedure patient required minimum assistance for transfers and supervision for ADLs. Patient did not regain his ability to ambulate. This injury led, unfortunately, to decreased independence and quality of life.

Conclusion: As palliative cryoablation therapy is used more frequently, physiatrists should be aware of such debilitating complication.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/spinal-cord-injury-and-severe-disability-after-palliative-percutaneous-spine-cryoablation-and-kyphoplasty-in-metastatic-renal-cell-carcinoma-a-case-report/