Diplopia developed by cervical traction after cervical spine surgery
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1–C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient’s symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient’s fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.
Abstract
Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1–C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient’s symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient’s fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.
참고문헌 (18)
- Metzner J, "Closed claims’ analysis", Best Pract Res Clin Anaesthesiol, 25, pp.263~276 (2011)
- Abd-Elsayed AA, "Diplopia following spine surgery : a case series", Open Neurosurg J, 4, pp.14~15 (2011)
- 조대철, "Abducens Nerve Palsy after Lumbar Spinal Fusion Surgery with Inadvertent Dural Tearing", 대한신경외과학회지, 46(6), pp.581~583 (2009), 대한신경외과학회
- Joo JD, "Isolated abducens nerve palsy due to cerebrospinal fluid leakage following lumbar discectomy : a rare clinical entity", Eur Spine J, 22(Suppl 3), pp.S421~S423 (2013)
- Khurana A, "Intracranial hypotension with a sixth cranial nerve palsy subsequent to massive thoracic CSF hygroma : a rare complication of thoracic disc excision", Eur Spine J, 22, pp.2047~2054 (2013)
- Nakagawa H, "Abducens nerve palsy as a rare complication of spinal surgery : a case report", J Orthop Sci, 8, pp.869~871 (2003)
- Sandon LH, "Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery : a case report", BMC Surg, 16, pp.47~ (2016)
- Thomas A, "Abducens nerve palsy associated with pseudomeningocele after lumbar disc surgery: a case report", Spine(Phila Pa 1976), 37, pp.E511~E513 (2012)
- Barsoum WK, "Cranial nerve palsy as a complication of operative traction", Spine(Phila Pa 1976), 24, pp.585~586 (1999)
- Althomali AT, "Diplopia after general anesthesia a post-operative complication or mere coincidence? case report", J Eye Cataract Surg, 2, pp.11~ (2016)
- Schievink WI, "Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension", JAMA, 295, pp.2286~2296 (2006)
- Blumenfeld H, "Neuroanatomy through clinical cases", pp.566~570 (2010), Sinauer Associates
- Miller NR, "Walsh & Hoyt’s clinical neuro-ophthalmology: the essentials", pp.365~367 (2016), Lippincott Williams & Wilkins
- Romero FR, "Microsurgical anatomy and injuries of the abducens nerve", Arq Neuropsiquiatr, 67, pp.96~101 (2009)
- Dengler BA, "Bilateral abducens nerve palsy following ligamentous C1-C2 distraction", Eur Spine J, 23(Suppl 2), pp.248~252 (2014)
- Master CL, "Vision diagnoses are common after concussion in adolescents", Clin Pediatr(Phila), 55, pp.260~267 (2016)
- Kumar N, "Blindness and rectus muscle damage following spinal surgery", Am J Ophthalmol, 138, pp.889~891 (2004)
- Hassen GW, "Diplopia from subacute bilateral subdural hematoma after spinal anesthesia", West J Emerg Med, 13, pp.108~110 (2012)