Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Diplopia developed by cervical traction after cervical spine surgery

  • Kim, Ji-Yoon (Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital) ;
  • Kim, Hyuna (Department of Ophthalmology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Kang, So Jeong (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Kim, Hyunjee (Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital) ;
  • Lee, Young-Seok (Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital)
  • Received : 2020.04.01
  • Accepted : 2020.07.11
  • Published : 2021.04.30
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Abstract

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

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References

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