[Sudden blindness following operative care of a multiply traumatized patient: posterior ischemic optic neuropathy].
A 32-year-old man had fallen from an 8-m high scaffolding and had suffered multiple traumatic injuries, such as compression fractures of the thoracic vertebrae (TV) 5-7 without incarceration of the spinal canal plus a distal femoral fracture. During surgery on the day of the accident, spondylodesis and dorsal stabilization of TV 4-7 using an internal fixator were carried out and the distal femoral fracture was stabilized with a dynamic condylar screw (DCS). On the day following the accident, the malposition of a pedicle screw located at the height of TV 4 and the borderline malposition of a pedicle screw of TV 7 were corrected. Between the day of the accident and day 8 after, the patient developed impaired vision and in the further course amaurosis associated with fixed pupils. No organopathy could be noticed which could have explained the sudden vision loss. A study of the literature was done, using the keywords "blindness" and "spine surgery." Only very few cases describing a connection of spine surgery and postoperative vision loss could be found. This article aims to elaborate on the few connections worked out in these investigations.
Schmoz
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Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Kliniken Bergmannstrost, Merseburger Strasse 165, 06112 Halle. susanne.schmoz@bergmannstrost.com
Wawro
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Weng
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Stuttmann
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Hofmann
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GO
D000328:Adult; D001766:Blindness / Q000175:diagnosis / Q000209:etiology*; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050815:Fractures, Compression / Q000175:diagnosis / Q000601:surgery*; D006212:Hallucinations / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery*; D009896:Optic Atrophy / Q000175:diagnosis / Q000209:etiology; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed