• Daniel Lubelski, Zachary Pennington, Daniel M Sciubba, Nicholas Theodore, and Ali Bydon.
• Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
• World Neurosurg. 2020 Jan 1; 133: e68-e75.

BackgroundHorner syndrome is an infrequently seen complication of anterior cervical discectomy and fusion (ACDF). Multicenter studies have reported a very low incidence, less than 0.1%.ObjectiveTo identify the incidence in, characteristics of, and postoperative course in patients in whom postoperative Horner syndrome developed after ACDF.MethodsWe performed a retrospective review of all patients who experienced Horner syndrome after ACDF for cervical degenerative disease at a single tertiary care institution between 2017 and 2018. A systematic review was then performed to identify studies investigating prevalence, diagnosis, and treatment of postoperative Horner syndrome after ACDF.ResultsOf 1116 patients at our institution who underwent ACDF, the incidence of Horner syndrome was 0.45%. C4/5 and C5/6 were the 2 most common surgical levels. The complication was noted to occur immediately after surgery, and at least partial improvement was identified in all patients an average 3.5 months after surgery (range, 10 days to 6 months). These findings were consistent with our systematic review of 21 studies that showed an incidence of 0.6% (range, 0.02% to 4.0%), the most common surgical level C5/6 (64%), and 82% of patients experiencing at least partial resolution of symptoms within 1 year (60.7% complete, 21.4% partial resolution).ConclusionHorner syndrome occurs in 0.6% of patients undergoing ACDF. Careful postoperative examination should reveal this complication, which may be underdiagnosed or underreported in larger multicenter case series. The majority of patients experience complete resolution of symptoms within 6 months to 1 year and can be treated conservatively and expectantly.Copyright © 2019 Elsevier Inc. All rights reserved.

29 keywords...

hide…