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Quadraplegia Case Settles

In a case involving an anterior cervical discectomy and fusion procedure, the patient suffered a spinal cord injury because the spine surgeon failed to carefully decompress the spinal cord. The surgeon did not use either an operating microscope or magnifying loupes but rather relied on his natural vision. It is generally held as a fundamental principle in the modern era of surgery that the surgeon must use magnified vision and illumination to better visualize the disc and osteophyte pathology at the level of the dura and spinal cord. The removal of disc fragments and osteophytes must be done in such a way as to not press on the dura or spinal cord in such a way that causes injury to the spinal cord or the cervical nerve roots. Sometimes the spinal cord is severely compressed from the underlying pathology and the risks of spinal cord injury are greater than normal however, in every case, great care must be taken to not injure the spinal cord and the nerve roots.
These principles are important in anterior cervical disc surgery and are not meant to be binding on all spine surgeries where the procedures are different.

Intraoperative blindness case settles

We have recently settled a case involving intentionally induced hypotension that was poorly managed and resulted in a unilateral posterior ischemic optic neuropathy that was irreversible. Although hypotension is not noted to be a contributing factor in the 2006 Anesthesia Guidelines, the unreasonable management of intraoperative hypotension in addition to other known risk factors can cause blindness and is a cause for a legal action 

Trigeminal Neuralgia

Lawrence B Schlachter MD JD neurosurgeon/attorney

In a recent legal case, the patient was suffering from severe facial pain, trigeminal neuralgia, that would not respond to any medical therapy. Patient elected to undergo a suboccipital microvascular decompression of the trigeminal nerve. The surgeon created the craniectomy opening in the wrong place and because of this error, he missed the opportunity to dissect along the cerebellopontine angle. The surgeon then injured the cerebellum during the ill fated exposure to the trigeminal nerve and caused neurological damage to the patient. The patient had deficts of cerebellar function and vertigo.

The legal claim alleged that the craniectomy was made in the wrong place and as such was negligent and below the standard of care. The claim also alleged that the surgeon should have stopped when he ran into problems with the exposure of the trigeminal nerve rather than continue with the high risk approach. The case was resolved early in the discovery process.

One of the cardinal principles of this surgery is to approach the trigeminal nerve by retracting the cerebellum medially along the petrous ridge. With the use of an operating microscope and careful technique, the operation can usually be safely performed.

Questions about the condition, the procedure and legal matters are open to discussion.

Lawrence B Schlachter MD JD

The Schlachter Law Firm. PC

602 Macy Dr, Roswell Ga 30075

Board Certified in Neurological Surgery

Member of the Georgia Bar