Miraculous recovery of perioperative acute uniocular loss of vision following spine surgery in prone position

Sakil Malik; Jishnu Chatterjee; Debanjana Mukherjee; Dipanjan Chowdhury

doi:10.18203/2349-2902.isj20251190

Authors

Sakil Malik Department of General Surgery, Manipal Hospital, Salt Lake, Kolkata, West Bengal, India https://orcid.org/0009-0002-1058-9480
Jishnu Chatterjee Department of General Surgery, Manipal Hospital, Salt Lake, Kolkata, West Bengal, India
Debanjana Mukherjee Department of Emergency Medicine, B.P. Poddar Hospital and Medical Research Limited, New Alipore, Kolkata, West Bengal, India
Dipanjan Chowdhury Department of Respiratory Medicine, I.P.G.M.E.R and S.S.K.M Hospital, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-2902.isj20251190

Keywords:

Lumbar canal stenosis, Left optic neuritis, Prone position, Peri operative complete visual loss, Retino-optic nerve pathway dysfunction

Abstract

An 18 years old female came to emergency with low back pain radiating to left lower limb for 8 months. The patient had no comorbidities as such and was hemodynamically stable with HR-72/min, BP-120/60 mmHg, Spo2-98% in room air, RBS-125 mg/dl. Patient was diagnosed with L5-S1 PIVD with Lumbar Canal Stenosis and was planned for L5-S1 instrumented spinal Stabilization with L5 laminectomy and discectomy under general anaesthesia. Preoperative status of the patient was stable. Perioperatively patient had uniocular left sided complete loss of vision for 3 days following which gradual improvement of vision to normal restoration of vision achieved after 4 months along with a diagnosis of left optic neuritis with severe retino-optic nerve pathway dysfunction.

Metrics

Metrics Loading ...

References

Berg KT, Harrison AR, Lee MS. Perioperative visual loss in ocular and nonocular surgery. Clin Ophthalmol. 2010;4:531–46. DOI: https://doi.org/10.2147/OPTH.S9262

Agarwal N, Hansberry DR, Goldstein IM. Cortical blindness following posterior lumbar decompression and fusion. J Clin Neurosci. 2014;21:155–9. DOI: https://doi.org/10.1016/j.jocn.2012.12.019

Goni V, Tripathy SK, Goyal T, Tamuk T, Panda BB, Bk S. Cortical blindness following spinal surgery: Very rare cause of perioperative vision loss. Asian Spine J. 2012;6:287-90. DOI: https://doi.org/10.4184/asj.2012.6.4.287

Delattre O, Thoreux P, Liverneaux P, Merle H, Court C, Gottin M, et al. Spinal surgery and ophthalmic complications: A French survey with review of 17 cases. J Spinal Disord Tech. 2007;20:302–7. DOI: https://doi.org/10.1097/01.bsd.0000211290.21766.04

Gayat E, Gabison E, Devys JM. Case report: Bilateral angle closure glaucoma after general anesthesia. Anesth Analg. 2011;112:126-8. DOI: https://doi.org/10.1213/ANE.0b013e3182009ad6

Epstein NE. The risks of epidural and transforaminal steroid injections in the spine: Commentary and a comprehensive review of the literature. Surg Neurol Int. 2013;4:74-93. DOI: https://doi.org/10.4103/2152-7806.109446

DePasse JM, Palumbo MA, Haque M, Eberson CP, Daniels AH. Complications associated with prone positioning in elective spinal surgery. World J Orthop. 2015;6:351–9. DOI: https://doi.org/10.5312/wjo.v6.i3.351

Emery SE, Daffner SD, France JC, Ellison M, Grose BW, Hobbs GR. Effect of head position on intraocular pressure during lumbar spine fusion: A randomized, prospective study. J Bone Joint Surg Am. 2015;97:1817-23. DOI: https://doi.org/10.2106/JBJS.O.00091

Baig MN, Lubow M, Immesoete P, Bergese SD, Hamdy EA, Mendel E. Vision loss after spine surgery: Review of the literature and recommendations. Neurosurg Focus. 2007;23:15. DOI: https://doi.org/10.3171/foc.2007.23.5.16

Wax MK. Prone positioning for head and neck reconstructive surgery. Head Neck. 2007;29(11):1041–5. DOI: https://doi.org/10.1002/hed.20650

Dharmavaram S, Jelish S, Nockels RP, Shea J, Mehmood R, Ghanayem A, et al. Effect of prone positioning systems on hemodynamic and cardiac function during lumbar spine surgery: an echocardiographic study. Spine. 2006;31(12):1388–93. DOI: https://doi.org/10.1097/01.brs.0000218485.96713.44

Poon K, Wu K, Chen C, Fung S, Lau AW, Huang C, et al. Acta Anaesthesiol Taiwan. 2008;46(2):57–60. DOI: https://doi.org/10.1016/S1875-4597(08)60026-0

Yuen VMY, Chow BFM, Irwin MG. Severe hypotension and hepatic dysfunction in a patient undergoing scoliosis surgery in the prone position. Anaesth Intensive Care. 2005;33(3):393–9. DOI: https://doi.org/10.1177/0310057X0503300317

Yu Y, Chen W, Chen L, Chen W. Ischemic orbital compartment syndrome after posterior spinal surgery. Spine. 2008;33(16):569–72. DOI: https://doi.org/10.1097/BRS.0b013e31817c55c2

Trethowan BA, Gillilard H, Popov AF, Varadarajan B, Phillips SA, McWhirter L, et al. A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting. J Cardiothorac Surg. 2011;6(1):154–60. DOI: https://doi.org/10.1186/1749-8090-6-154

Chung MS, Son JH. Visual loss in one eye after spinal surgery. Korean J Ophthalmol. 2006;20:139–42. DOI: https://doi.org/10.3341/kjo.2006.20.2.139