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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1782610
Case Report

Unilateral Vision Loss after Posterior Fixation for Traumatic Atlantoaxial Dislocation: A Case Report with Literature Review

Guramritpal Singh
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Ved Prakash Maurya 
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Kamlesh Singh Bhaisora
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Arun Kumar Srivastava
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Sanjay Behari
2   Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
,
Raj Kumar
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Abstract

Postoperative vision loss following spine surgery is a rare and devastating complication with variable incidence. Various risk factors have been identified in the literature. A 16-year-old male presented with neck pain, spastic quadriparesis, and tingling paraesthesia in the left upper limb for the past 3 years. Radiological workup was suggestive of atlantoaxial dislocation with occipitalization of the posterior arch of the atlas (C1). The patient was prone to a horseshoe headrest and underwent occipito-C2-C3 fixation by removing the posterior rim of foramen magnum. Postoperatively, the patient complained of loss of vision in the right eye. Ophthalmology evaluation revealed a loss of perception of light in the right eye due to central retinal artery occlusion. An injectable steroid was started, but there was no improvement in vision in the involved eye. Proper head positioning and avoidance of intraoperative hypotension are modifiable factors to avoid such devastating complications.

Keywords

prone position - ischemia - vision loss - atlantoaxial dislocation

Authors' Contributions

V.P.M. conceptualized and designed the study. R.K. and S.B. provided administrative support. K.S.B. helped in provision of study materials or patients. G.S. contributed to collection and assembly of data. V.P.M. and A.K.S. helped in data analysis and interpretation. All the authors helped in manuscript writing and provided final approval for the manuscript.




Publication History

Article published online:
07 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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