Horner’s Syndrome After Anterior Decompression And Fusion For Cervical Spine Pathologies: Report Of Two Cases

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Volume 5 | Issue 1 | January-June 2020 | Page: 6-8 | Tomotaka Umimura, Satoshi Maki, Masao Koda, Seiji Ohtori

Authors : Tomotaka Umimura [1], Satoshi Maki [1], Masao Koda [2], Seiji Ohtori [1]

[1] Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8677, Japan.
[2] Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaragi, 305-8575 Japan.

Address of Correspondence
Dr. Tomotaka Umimura,
Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8677, Japan.
Email : adna4547@gmail.com

Abstract

Introduction: Horner’s syndrome is caused by impairment of the sympathetic trunk, resulting in associated ptosis, miosis, and anhidrosis. The cervical sympathetic trunk is sometimes damaged during an anterior approach to the lower cervical spine. We report two cases of Horner’s syndrome after anterior decompression and fusion for lower cervical spine pathologies.
Case Presentation: Case 1 was in a 58-year-old Japanese woman with a herniated C5-6 intervertebral disc presenting myelopathy who underwent anterior cervical discectomy and fusion of C5–C6. After the operation, miosis, and anhidrosis of the right face occurred and the symptoms continued for more than 15 years. Case 2 was in a 40-year-old Japanese woman whose diagnosis was flexion myelopathy with kyphosis at C5–C6 and canal stenosis, so she underwent anterior cervical C5-6 discectomy and fusion of C5–C6. Immediately after surgery, ptosis and miosis occurred, which lasted for 4 months.
Conclusion: Horner’s syndrome tends to occur during anterior cervical spine procedures, especially at the lower level, and the syndrome may be transient or irreversible. During an anterior approach to the lower cervical spine, taking care not to damage the sympathetic trunk is important to avoid this complication.
Keywords: Horner’s syndrome, Anterior cervical spine surgery, Complication.

References

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How to Cite this Article: Umimura T, Maki S, Koda M, Ohtori S | Horner’s Syndrome After Anterior Decompression And Fusion For Cervical Spine Pathologies: Report Of Two Cases | International Journal of Spine| January-June 2020; 5(1): 6-8 .

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Wide Open Laminectomy, Posterior Decompression and Discectomy in Lumbar Spine with Preservation of Posterior Ligamentous Complex in Cauda Equina Syndrome – Case Series, Early Outcome and Literature Review

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Volume 5 | Issue 1 | January-June 2020 | Page: 9-11 | Ong Kean Loong, Ng Bing Wui, Thuraikumar Kanniah, Wang Chee Seiang, Lim Sze Wei, Nor Azlin Zainal Abidin

Authors : Ong Kean Loong [1], Ng Bing Wui [2], Thuraikumar Kanniah [1], Wang Chee Seiang [1], Lim Sze Wei [1], Nor Azlin Zainal Abidin [1]

[1] Spine unit, Department of Orthopaedic, Hospital Sungai Buloh, Malaysia.
[2] Department of Orthopaedic, Hospital Segamat, Malaysia.

Address of Correspondence
Dr. Ng Bing Wui,
Spine unit, Department of Orthopaedic, Hospital Sungai Buloh, Malaysia.
Email : bingwuing@gmail.com

Abstract

Introduction: Spinous process osteotomy has been described as an alternative approach to allow better visualization during laminectomy and decompression of the spinal cord in cases of lumbar spinal stenosis.1 In this study, the authors describe the experience and early outcome of using this technique in treatment of Cauda Equina Syndrome.
Method: This is a retrospective study conducted between March 2018 until March 2019. Cases of Cauda Equina Syndrome treated with spinous process osteotomy, wide laminectomy, decompression and discectomy without instrumentation will be included in this study. Owestry Disability Index (ODI) and outcome of patients will be studied.
Result: 5 cases were found during the study period. All patients have shown marked improvement in terms of neurology and ODI score.
Conclusion: Spinous process osteotomy, wide laminectomy and discectomy can be used effectively for the treatment of Cauda Equina Syndrome. This study intend to be a pilot study in understanding the effectiveness and early outcome of patients treated with this approach. Larger prospective study is needed to provide meaningful comparison between this technique with the conventional approach used in treatment of Cauda Equina Syndrome.
Keywords: Cauda Equina Syndrome, Spinous process osteotomy, Posterior ligamentous complex.

References

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How to Cite this Article: Loong OK, Wui NB, Kanniah T, Seiang WC, Wei LS, Abidin NAZ | Wide Open Laminectomy, Posterior Decompression and Discectomy in Lumbar Spine with Preservation of Posterior Ligamentous Complex in Cauda Equina Syndrome – Case Series, Early Outcome and Literature Review | International Journal of Spine| January-June 2020; 5(1): 9-11.

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Revision Spine With Hartshill and Sublaminar Wiring in Operated Osteoporotic Fracture- A Case Note

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Volume 5 | Issue 1 | January-June 2020 | Page: 2-5 | Shailesh Hadgaonkar, Vivek Vincent, Pradhyumn Rathi, Parag Sancheti, Ashok Shyam

Authors : Shailesh Hadgaonkar [1], Vivek Vincent [1], Pradhyumn Rathi [1], Parag Sancheti [1], Ashok Shyam [1]

[1] Department of Spine, Sancheti Institute of Orthopedics and Rehabilitation

Address of Correspondence
Dr. Pradhyumn Rathi,
Row House No.1, Shamail complex, Balaji nagar, Bhayander west Thane 401101
E-mail: pradhyumnrathi@gmail.com

Abstract

Introduction: Osteoporotic vertebral compression fractures (OVCF) are one of the commonest fractures seen in day to day practise. We present a unique case of failure of pedicle screw instrumentation in OVCF revised by sublaminar wiring (SLW).
Case report: A 70 year old lady with old operated osteorporotic fracture with sagittal imbalance and implant loosening was revised with single spinal rectangular loop and sublaminar wires (SLW).
Conclusion: Pedicle screws constructs for short segment fixation are rigid and biomechanically superior with greatest pull out strength, which mainly depends on bone mineral density. But, sublaminar wires should be considered far more superior in severely osteoporotic bone.
Keywords: Bone density, Bone wires, Compression, Fractures, Osteoporosis, Pedical screws, Spinal fractures.

References

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How to Cite this Article: Hadgaonkar S, Vincent V, Rathi P, Sancheti P, Shyam A | Revision spine with Hartshill and Sublaminar wiring in operated osteoporotic fracture- A case note| International Journal of Spine| January-June 2020; 5(1): 2-5..

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A prospective Study of Dural Tears among 430 cases of Lumber Spine Surgery

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Volume 5 | Issue 1 | January-June 2020 | Page: 12-15 | Md. Alauddin, A.H.M Tanvir Hasan Siddiquee, Md. Matiur Rahman, Malay Kumar Roy, Shahidul Islam khan, Md. Abdullah Al Mahmud

Authors : Md. Alauddin [1], A.H.M Tanvir Hasan Siddiquee [1], Md. Matiur Rahman [1], Malay Kumar Roy [1], Shahidul Islam khan [2], Md. Abdullah Al Mahmud [3]

[1] Department of Orthopaedic Surgery, Mymensingh Medical College, Mymensingh, Bangladesh.
[2] Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
[3] Department of Orthopaedic Surgery, Rangpur Medical College, Rangpur, Bangladesh.

Address of Correspondence
Dr. Md. Alauddin,
Department of Orthopaedic Surgery, Mymensingh Medical College, Mymensingh, Bangladesh.
E-mail: alauddin.md.k49@gmail.com

Abstract

Inadvertent Dural tear (DT) is a possible feared complication of spinal surgery. This is a prospective study of 430 consecutive patients with different types of lumber spinal surgery within the period of ‘January 2010 to December 2018′. Aim of the study is to evaluate incidence of dural tear (DT) with risk factors, compare between DT and non DT group with outcome. Incidence of dural tear were more on patients with older age, degenerative spinal stenosis, spondylolisthesis, re-operative surgery, multiple level surgery and with instrumentation. No significance sex difference found. Postoperative complications were more and outcome poor in DT group in comparison to non DT group. Every spine surgeon should be aware of possible dural tear and must know how to deal it.
Keywords: Dural Tear (DT); DT group; Non DT group.

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How to Cite this Article: Alauddin M, Siddiquee AHMTH, Rahman MM, Roy MK, khan SI, Mahmud MAA | A prospective Study of Dural Tears among 430 cases of Lumber Spine Surgery | International Journal of Spine| January-June 2020; 5(1): 12-15.

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