Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2016

Open Access 01-12-2016 | Case report

Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery: a case report

Authors: Luiz Henrique Dias Sandon, Gun Choi, EunSoo Park, Hyung-Chang Lee

Published in: BMC Surgery | Issue 1/2016

Login to get access

Abstract

Background

Thoracic disc surgeries make up only a small number of all spine surgeries performed, but they can have a considerable number of postoperative complications. Numerous approaches have been developed and studied in an attempt to reduce the morbidity associated with the procedure; however, we still encounter cases that develop serious and unexpected outcomes.

Case Presentation

This case report presents a patient with abducens nerve palsy after minimally invasive surgery for thoracic disc herniation with an intraoperative spinal fluid fistula. A literature review of all cases related to this complication after spine surgery is included.
Despite the uncommon nature of this type of complication, understanding the procedure itself, the principle occurrences and outcomes following the procedure, the physiopathogical features of abducens nerve palsy, and the possible adverse effects of spinal surgery, including minimally invasive procedures, can enable an early diagnosis of complications and facilitate the procedure.

Conclusions

In spite of being very rare and multifactorial, uni- or bilateral abducens nerve paralysis carries significant morbidity and can occur as a postoperative complication after conventional or minimally invasive spine surgery. This condition requires an accurate diagnosis and adequate multidisciplinary follow up.
Literature
1.
Benzel EC. Biomechanics of spine stabilization. Stuttgart, Rolling Meadows: American Association of Neurological Surgeons, Thieme Medical Publishers; 2001.
2.
Yoshihara H, Yoneoka D. Comparison of in-hospital morbidity and mortality rates between anterior and nonanterior approach procedures for thoracic disc herniation. Spine (Phila Pa 1976). 2014;39:E728–33.CrossRef
3.
Berjano P, Garbossa D, Damilano M, Pejrona M, Bassani R, Doria C. Transthoracic lateral retropleural minimally invasive microdiscectomy for T9-T10 disc herniation. Eur Spine J. 2014;23:1376–8.CrossRefPubMed
4.
5.
Russo A, Balamurali G, Nowicki R, Boszczyk BM. Anterior thoracic foraminotomy through mini-thoracotomy for treatment of giant thoracic disc herniations. Eur Spine J. 2012;21:S212–20.CrossRefPubMed
6.
Rosenthal D, Dickman CA. Thoracoscopic microsurgical excision of herniated thoracic discs. J Neurosurg. 1998;89:224–35.CrossRefPubMed
7.
Uribe JS, Dakwar E, Cardona RF, Vale FL. Minimally invasive lateral retropleural thoracolumbar approach: cadaveric feasibility study and report of 4 clinical cases. Neurosurgery. 2011;68(1 Suppl Operative):32–9.PubMed
8.
Uribe JS, Dakwar E, Le TV, Christian G, Serrano S, Smith WD. Minimally invasive surgery treatment for thoracic spine tumor removal: a mini-open, lateral approach. Spine (Phila Pa 1976). 2010;35:S347–54.CrossRef
9.
Khurana A, Brousil J, Russo A, Evans A, Quraishi NA, Boszczyk BM. Intracranial hypotension with a sixth cranial nerve palsy subsequent to massive thoracic CSF hygroma: a rare complication of thoracic disc excision. Eur Spine J. 2013;22:2047–54.CrossRefPubMedPubMedCentral
10.
Nakagawa H, Kamimura M, Uchiyama S, Takahara K, Itsubo T, Miyasaka T. Abducens nerve palsy as a rare complication of spinal surgery: a case report. J Orthop Sci. 2003;8:869–71.CrossRefPubMed
11.
Thomas A, Shetty AP, Rajasekaran S. Abducens nerve palsy associated with pseudomeningocele after lumbar disc surgery. Spine. 2012;37:E511–3.CrossRefPubMed
12.
Barsoum WK, Mayerson J, Bell GR. Cranial nerve palsy as a complication of operative traction. Spine. 1999;24:585–6.CrossRefPubMed
13.
Abd-Elsayed AA, Barsoum W, Bell G, Guirguis M, Farag E. Diplopia following spine surgery: a case series. Open Neurosurg J. 2011;4:14–5.CrossRef
14.
Zada G, Solomon TC, Giannotta SL. A review of ocular manifestations in intracranial hypotension. Neurosurg Focus. 2007;23, E8.CrossRefPubMed
15.
Cho DC, Jung ES, Chi YC. Abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing. Korean Neurosurg Soc. 2009;46:581–3.CrossRef
16.
17.
Wilson-Pauwels L, Akesson E, Stewart P, Spacey S. Cranial Nerves in health and disease. Hamilton: Be Decker Inc; 2002.
18.
Joo JD, Yoon YH, Kim KJ, Jahng TA, Kim HJ. Isolated abducens nerve palsy due to cerebrospinal fluid leakage following lumbar discectomy: a rare clinical entity. Eur Spine J. 2013;22:S421–3.CrossRefPubMed
19.
Metadata
Title
Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery: a case report
Authors
Luiz Henrique Dias Sandon
Gun Choi
EunSoo Park
Hyung-Chang Lee
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2016
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-016-0162-1

Other articles of this Issue 1/2016

BMC Surgery 1/2016 Go to the issue

Case report

A case report of successful treatment of 90° knee flexion contracture in a patient with adult-onset Still’s disease

Case report

Emergency radiological examination of the externally stabilized pelvis – there is a catch to it: lessons learned from two cases with symphyseal disruption despite initial inconspicuous computed tomography

Retraction Note

Retraction Note: Observational study: daily treatment with a new compound “tradamixina” plus serenoa repens for two months improved the lower urinary tract symptoms

Research article

Proteinuria can predict prognosis after liver transplantation

Case report

A case report of simultaneous orthotopic liver transplantation and jejunectomy

Technical advance

A locking compression plate as an external fixator for treating infected nonunion of the humeral diaphysis