© Springer International Publishing Switzerland 2017
Massimiliano Visocchi, H. Maximilian Mehdorn, Yoichi Katayama and Klaus R. H. von Wild (eds.)Trends in Reconstructive NeurosurgeryActa Neurochirurgica Supplement12410.1007/978-3-319-39546-3_33Focus on Functional Delayed Central Sleep Apnea Following Cervical Laminectomy. An Example of Respiratory Dysfunction in Restorative Neurosurgical Procedures
(1)
Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy
(2)
Division of Neurosurgery, Department of Neurosciences, Policlinico “G. Rodolico” University Hospital, Catania, Italy
(3)
Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Palermo, Italy
(4)
Department of Neuroscience, Neurosurgical Clinic, University of Messina, Messina, Italy
Abstract
In sleep-related breathing disorders, sleep apnea is a clinical symptom that can be categorized as obstructive sleep apnea (OSA) or mixed apnea by analysis using polysomnography. The occurrence of delayed central sleep apnea (CSA) is an extremely rare complication of cervical laminectomy for spondylotic myelopathy. So far only three studies concerning such an event have been reported in the literature. Naim-ur-Rahman, in 1994, reported a case of postoperative CSA following C3-C6 laminectomy, and Visocchi and colleagues, in 2014, in two studies, stressed the lack of association with any other neurological sign of spinal cord damage. No definitive mechanism has been recognized so far for delayed CSA after cervical laminectomy. A transient dysfunction of the reticulo-spinal fibers directed to the nucleus of the phrenic nerve can be speculated, although neither emi-diaphragm paralysis, nor any prominent nocturnal sleep-related disorders are associated with this delayed CSA.