Ignorance shown on arterial waveform and impending recurrent laryngeal nerve injury was missed during anterior cervical spine surgery

• Author Details:   
• Raksha Anand
• Deepak Ganjigere Palaksha ^*

Anterior cervical spine surgeries pose a risk to the recurrent laryngeal nerve (RLN), especially with right-sided roaches. A 4-year-old girl with T1 aneurysmal bone cyst and C7–T2 spondylolisthesis underwent T1 corpectomy and anterior fixation. Intraoperatively, dampened arterial waveform from a right radial arterial line coincided with retractor placement. Postoperatively, transient hoarseness suggested RLN neuropraxia. The dampened waveform likely reflected subclavian artery compression, anatomically adjacent to the right RLN. Aberrant intraoperative blood pressure or pulse oximeter readings on the ipsilateral limb may serve as surrogate markers for RLN compression, warranting retractor adjustment.