Paraplegia following a simple surgery, such as a thoracotomy, is a disaster with obvious legal implications. Most documented cases involve arterial bleeding. Unexpected paraplegia following a simple lung resection is a devastating injury. Fortunately, it rarely occurs. The incidence of paraplegia after thoracotomy is unknown but has been estimated to be approximately 0.08%. The culprit may be the effort to control bleeding using electrocautery or oxidized cellulose. The oxidized cellulose has been found to migrate into the spinal canal causing spinal block. Other factors implicated in postthoracotomy paraplegia include intraoperative blood loss, hypotension, ligation of intercostal arteries and thrombosis of the anterior spinal artery.
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