Rare Complications of Cervical Spine Surgery: Horner's Syndrome (original) (raw)
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Horner Syndrome After Anterior Revision Surgery for Cervical Spondylotic Myelopathy
JBJS Case Connector, 2018
Case: We report a case of postoperative left-sided Horner syndrome (blepharoptosis, miosis, and anhidrosis) after revision surgery for cervical spondylotic myelopathy. A C4 corpectomy and an anterior cervical fusion from C3 to C5 were performed through a left longitudinal approach in a patient with a surgical history of an anterior discectomy and a fusion from C5 to C6. One year after the revision surgery, the patient had recovered from the anhidrosis and the miosis, but the blepharoptosis was not fully resolved. Conclusion: Horner syndrome resulting from surgical injury to the ipsilateral cervical sympathetic chain is a very rare complication of anterior spine surgery that has been reported when the lower cervical levels have been approached. Awareness of this important cervical structure may help to avoid this complication.
Complications of Anterior and Posterior Cervical Spine Surgery
Asian Spine Journal, 2016
Cervical spine surgery performed for the correct indications yields good results. However, surgeons need to be mindful of the many possible pitfalls. Complications may occur starting from the anaesthestic procedure and patient positioning to dura exposure and instrumentation. This review examines specific complications related to anterior and posterior cervical spine surgery, discusses their causes and considers methods to prevent or treat them. In general, avoiding complications is best achieved with meticulous preoperative analysis of the pathology, good patient selection for a specific procedure and careful execution of the surgery. Cervical spine surgery is usually effective in treating most pathologies and only a reasonable complication rate exists.
Global Spine Journal, 2016
Study Design Retrospective review of prospectively gathered data. Objective To report the rate and impact of perioperative complications in cervical spine surgery. To our knowledge, no prior study of the cervical spine has analyzed a large prospectively gathered data set for adverse events, based on surgical subgroup. Methods The ProSTOS database features prospectively documented perioperative adverse events for 1,269 patients who had cervical spine surgery at multiple centers in North America between 2008 and 2011. We subgrouped patients by approach, whether surgery was a primary or revision operation, and by the number of levels involved. Multivariate analysis with stepwise logistic regression was used to relate complication rates to gender, age, smoking status, body mass index, approach, revision status, and number of levels involved. Follow-up was 41%. Results Adverse events occurred significantly more frequently in posterior and combined procedures than in anterior procedures. ...
Intraoperative Complications During Surgery on the Posterior Cervical Spine
Seminars in Spine Surgery, 2009
Intraoperative complications during posterior spinal surgery are best avoided by awareness of which complications are possible during each portion of the surgery. Neurologic injury, vascular injury, and mechanical instability are the major complications that occur during the posterior cervical surgery. The relevance of positioning, tissue resection, instrumentation, and wound closure to each complication is considered. Preoperative planning, understanding each patient's anatomy, optimization in surgical positioning, and use of appropriate surgical tools form the basis for avoiding these complications. Early recognition intraoperatively, using neurologic monitoring and awareness of changes to the anatomical structures, is essential in salvaging the best chance for a successful outcome. Semin Spine Surg 21:156-160
Surgical Disorders of the Cervical Spine: Presentation and Management of Common Disorders
Journal of Neurology, Neurosurgery & Psychiatry
his man needs to see a Doctor!" So wrote an exasperated neurologist after reviewing a patient on the neurosurgical ward. Unfortunately this comment still springs to mind when one considers the clinical management of some cervical spine problems. Magnetic resonance imaging (MRI) scanning has led to a tidal wave of referrals of cervical spine problems to neurosurgeons. However, in many cases, the problem is more apparent on the scan than clinical assessment. MRI scanning cannot replace thoughtful history taking and clinical examination, and does not provide the necessary information for diagnosis and treatment. As a rule of thumb appropriate management depends in equal part on history, examination, and investigations.
Cervical Disc Herniation and Central Horner Syndrome
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2016
A fifty-five years-old patient with complaints of neck and shoulder pain for a week, without reference to a triggering factor, namely exercise or a traumatic event. The symptoms had increased in the 24 hours previous to the hospital observation, without any relief with immobilization or postural correction. Four hours after pain exacerbation, he described motor deficit of right side limbs, without other neurological disorder.
Anterior cervical spine surgical complications: Safety comparison between teacher and student
Surgical Neurology International, 2021
Background: Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience. Methods: We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years’ experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson’s Chi-square and Fisher’s test). Results: The to...
Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery
Global spine journal, 2017
Retrospective cohort study of prospectively collected data. To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery. A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury. In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged from 0.0% to 0.24%. Of the 3 patients with quadriplegia, one underwent anterior-only surgery with 2-level cervical corpectomy, one underwent anterior surgery with corpectomy in addition to posterior surgery, and one underwent posterior decompression and fusion surgery alone. One patient had complete neurologic recovery, on...
International journal of spine surgery, 2018
Risk of death is important in counseling patients and improving quality of care. Incidence of death in cervical surgery is not firmly established due to its rarity and limited sample sizes, particularly in the context of different surgeries, demographics, and risk factors. Particularly, different patient risk profiles may have varying degrees of risk in terms of surgeries, comorbidities, and demographics. This study aims to use a large patient cohort available on a national database to study the prevalence of death associated with cervical spine surgery. This study was a retrospective review of the Nationwide Inpatient Sample (NIS) years 2003-2012. A total of 342 477 patients were identified by codes undergoing spinal fusion or decompression for disc degeneration, stenosis, spondylosis, myelopathy, postlaminectomy syndrome, scoliosis, or neck pain associated with the cervical region. Patients with malignancy were excluded from analysis. Incidence of mortality was assessed by χ tests...