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

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


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.


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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

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


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.


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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

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


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.


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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

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


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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2. Hiroyuki Yoshira and Daisuke Yonevka.Incidental Dural Tears in spine surgery: analysis of a nationwide data base. Eur Spine J. 2014Feb; 23(2): 389-394.published online 2013 Nov9. PMCID: PMC 3906460.
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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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Result of Study Of Transforaminal Lumbar Interbody Fusion Surgery

Volume 4 | Issue 2 | July – Dec 2019 | Bhavesh R. Namsha, Udaygiri H. Meghnathi, Bhavik K. Ahir | Page 2-6

Authors : Bhavesh R. Namsha, Udaygiri H. Meghnathi, Bhavik K. Ahir [1]

[1] Department of Orthopaedics, SSG Hospital & Medical college Baroda, Gujarat, India

Address of Correspondence
Dr. Udaygiri H. Meghnathi,
Department of Orthopaedics, SSG Hospital & Medical college Baroda, Gujarat, India
Email: udaymeghnathi@gmail.com


Background: Low back pain is one of the most common reported problem affecting spine. The most common causes of Low back pain are herniated discs, lumbar canal stenosis, degenerative disc disease, spondylolisthesis. Over the past few decades, new treatments and technologies are being implemented to treat spinal disorders to improve patient outcome. The Main objective of study is to access clinical and Radiological result that is obtained with Transforaminal lumbar interbody fusion as a treatment of severe back pain and degenerative disc diseases & to describe outcomes following Transforaminal lumbar interbody fusion (TLIF) surgery.
Methods: A Total of 15 patients who had back pain with degenerative disc disease were operated by TLIF through period from July 2017 to July 2018. Results were measured using the Visual Analogue Scale(VAS) and Oswestry Disability Index (ODI).
Results: Marked improvement in back pain according to VAS. Pre operative Average VAS Score was 7 and post operative average VAS score at 6 month follow up was 1.73. According to ODI score pre operative average ODI score was 66.53 and post operative 6 month ODI score was 18.53
Conclusion: From this study we have concluded that Transforaminal lumbar interbody fusion (TLIF) is a safe and effective method of achieving spinal fusion in patients with degenerative disc disease & low grade spondylolisthesis and thereby reduces back pain and improves patient’s disability score
Keywords: transforaminal lumbar interbody fusion- TLIF, Visual Analogue Scale- VAS, Oswestry Disability Index- ODI, PEEK

How to Cite this ArticleNamsha B R, Meghnathi U H, Ahir B K. Result of Study Of Transforaminal Lumbar Interbody Fusion (TLIF) Surgery. International Journal of Spine July-Dec 2019; 4(2): 2-6.

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Management Of Thoracolumbar Fractures in Adults: Current Algorithm

Volume 4 | Issue 2 | July – December 2019  | Vibhu Krishnan Viswanathan, Rishi Mugesh Kanna | Page 10-19

Authors : Vibhu Krishnan Viswanathan [1], Rishi Mugesh Kanna [1]

[1] Department of Orthopaedics, Ganga Hospital, Sai Baba Colony, Coimbatore, India.

Address of Correspondence
Dr. Rishi Mugesh Kanna,
Spine Surgeon, Ganga Hospital, Sai Baba Colony, Coimbatore, India.
E-mail: rishiortho@gmail.com


Thoraco-lumbar (TL) fractures are the most common sites for spinal injuries. The severity of these injuries can range from minor, un-displaced fractures amenable to conservative management to highly complex, unstable fractures requiring surgical interventions. There is still considerable ambiguity on various issues related to the management of these vertebral injuries. The current article addresses several crucial questions related to the management of TL spinal fractures. An elaborate search was performed on standard medical search engines including pubmed, google and medline databases using keywords “adult TL fractures”, adult thoracolumbar fractures”, “adult thoracolumbar injuries”, “adult thoracolumbar spinal injuries”, “spinal injuries” and “spinal fractures”. Based on this comprehensive narrative review, we have discussed the key consensus of the existing literature on various aspects of management of these fractures. Currently the most useful system for defining TL fractures is the AO classification system. The best initial imaging modality is computerize tomography (CT) scan, with magnetic resonance imaging (MRI) being the most useful modality in AO type B2 injuries. All patients with AO types B and C injuries require surgical intervention. The current literature is shifting in favor of posterior approach, in view of less complications and morbidity associated with these surgeries. The role of decompression in enhancing neurological recovery and the need for surgical fusion in addition to instrumentation in TL fractures are still controversial. The current literature is strongly against the use of high dose steroids in acute TL fractures with SCI.
Key words: Thoraco-lumbar fractures, AO Spine classification, Imaging modalities, Fracture fixation

How to Cite this Article: Viswanathan V K, Kanna R M | Management of thoracolumbar fractures in
adults: Current algorithm | International Journal of Spine | July-December 2019; 4(2): 10-19.

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