Tourniquet Paralysis May Reflect Injury of Muscle Spindles: A Case Report

Objective: Knee operation using pneumatic tourniquet may cause weakness of the quadriceps femoris muscle. A patient with a bilateral paresis of the quadriceps femoris muscles for two months postoperatively was studied. There was also immediate unbearable pain of the lower extremities after DBX-reconstruction of bilateral patellar chondrodysplasia.

Methods: ENMG and lumbar magnetic stimulation (MEP) follow-up.

Results: There was no distinct lesion of the motor axons of the femoral or other nerves in ENMG or MEP six weeks postoperatively. After a follow-up of eight months, the paresis was subsided and a complete recovery took place in two years.

Conclusion: High pressure of the tourniquet may injure muscle spindles. Decreased Ia-afferent activity may severely inhibit voluntary motor effort.