Kueper Janina, Loftus Michael L, Boachie-Adjei Oheneba, Lebl Darren
Spine and Scoliosis Service, Hospital for Special Surgery, New York, NY.
Am J Orthop (Belle Mead NJ). 2015 Nov;44(11):E465-8.
Posterior reversible encephalopathy syndrome (PRES) is a rare cause of temporary postoperative visual loss (POVL) after spinal deformity surgery. We report on 2 patients diagnosed with PRES after spinal deformity surgery, who were closely examined postoperatively. A 78-year-old woman with severe disability due to degenerative lumbar spondylosis after laminectomy was treated with transpsoas lumbar interbody fusion from L1 to L4 and posterior spinal fusion from T10 to pelvis. She developed confusion and bilateral visual loss on postoperative day 7. A second patient, a 51-year-old woman with progressive pain and decompensation caused by adult scoliosis, was treated with posterior spinal fusion from T3 to pelvis and interbody fusion from L4 to S1 via a presacral interbody fusion approach. She developed bilateral visual loss on postoperative day 15. Both patients achieved a complete recovery of their vision after medical management of PRES. Timely diagnosis of PRES and prompt intervention allow for a good patient prognosis and complete recovery of eyesight.
后部可逆性脑病综合征（PRES）是脊柱畸形手术后暂时性术后视力丧失（POVL）的罕见原因。我们报告2例脊柱畸形手术后被诊断为PRES的患者，术后对其进行了密切检查。一名78岁因退行性腰椎管狭窄症行椎板切除术后严重残疾的女性，接受了L1至L4经腰大肌腰椎椎间融合术及T10至骨盆后路脊柱融合术。她在术后第7天出现意识模糊和双侧视力丧失。第二名患者是一名51岁因成人脊柱侧弯导致进行性疼痛和失代偿的女性，接受了T3至骨盆后路脊柱融合术及经骶前椎间融合术L4至S1椎间融合术。她在术后第15天出现双侧视力丧失。两名患者在对PRES进行药物治疗后视力均完全恢复。及时诊断PRES并迅速干预可使患者预后良好且视力完全恢复。
