Umimura Tomotaka, Maki Satoshi, Koda Masao, Furuya Takeo, Ohtori Seiji
Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JPN.
Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN.
Cureus. 2021 Jul 26;13(7):e16633. doi: 10.7759/cureus.16633. eCollection 2021 Jul.
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 1 was in a 58-year-old woman with a herniated C5-6 intervertebral disc presenting myelopathy who underwent anterior cervical discectomy and fusion of C5-6. 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 woman whose diagnosis was flexion myelopathy with kyphosis at C5-6 and canal stenosis, so she underwent anterior cervical C5-6 discectomy and fusion of C5-6. Immediately after surgery, ptosis and miosis occurred, which lasted for four months. 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.
霍纳综合征由交感神经干受损引起，导致患侧上睑下垂、瞳孔缩小和无汗。在下颈椎前路手术过程中，颈交感神经干有时会受到损伤。我们报告两例因下颈椎病变行前路减压融合术后出现霍纳综合征的病例。病例1为一名58岁女性，患有C5-6椎间盘突出伴脊髓病，接受了颈椎前路椎间盘切除及C5-6融合术。术后，右侧面部出现瞳孔缩小和无汗，症状持续超过15年。病例2为一名40岁女性，诊断为C5-6节段后凸畸形伴椎管狭窄的屈曲型脊髓病，因此接受了颈椎前路C5-6椎间盘切除及C5-6融合术。术后立即出现上睑下垂和瞳孔缩小，持续了四个月。霍纳综合征在下颈椎前路手术过程中容易发生，尤其是在较低节段，该综合征可能是短暂的或不可逆的。在下颈椎前路手术中，注意避免损伤交感神经干对于避免这种并发症很重要。
