Macías ÁD, Grimaldo UE, Castillo CVD

Language: English
References: 19
Page: 308-313
PDF size: 1345.07 Kb.

ABSTRACT

Introduction: Horner’s syndrome (HS) may occur after cervical spine surgery as a result of injury or traction of the cervical sympathetic chain during anterior approaches. The literature reports low incidence rates (0.06-0.6%); however, cases continue to be documented, particularly in technically demanding surgical scenarios. Objective: to estimate the incidence, describe the clinical course, and identify technical considerations associated with postoperative Horner’s syndrome in a consecutive cohort of cervical spine surgeries, and to compare the findings with those reported in the literature. Material and methods: a retrospective review was conducted of all cervical spine surgeries performed by two spine surgeons between October 1, 2019, and September 30, 2025, at three private hospitals in Guadalajara, Mexico. Demographics, surgical approach, operated levels, procedure type, complications, and clinical course were recorded. Minimum follow-up was 12 months in patients who reached this period. Results: forty-two patients were included (mean age 57.8 ± 12.4 years; 61.9% male). The most common approach was right anterior (90.5%), and anterior cervical discectomy and fusion was the predominant procedure (66.7%). Postoperative complications occurred in 12 patients (28.5%), most frequently dysphagia and radiculopathy (7.1% each). Two patients (4.7%) developed postoperative Horner’s syndrome, both with immediate onset and partial clinical improvement documented at three months. Conclusions: in this consecutive cohort, the incidence of postoperative Horner’s syndrome was 4.7%, higher than that reported in the literature (0.06-0.6%). Technical conditions such as revision surgery, extensive dissection, calcified pathology, and prolonged operative time may be associated with its occurrence. Early recognition and explicit inclusion of this complication in the informed consent process should be considered in anterior cervical spine surgery, particularly in complex cases.

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