High Thoracic Disc Herniation Causing Horner Syndrome with the Intraoperative Finding of Conjoined Nerve Root Compression

Abstract

Although high thoracic disc herniation is rare, its diagnosis should be considered when patients present with radicular arm pain and Horner syndrome. A high index of suspicion should be maintained for nerve root anomalies to limit iatrogenic injury and to ensure successful decompression.

Horner Syndrome After Anterior Revision Surgery for Cervical Spondylotic Myelopathy: A Very Rare Complication

“…Horner syndrome also can be a complication of spinal pathology and/or surgery. Recently, it has been reported as a presentation of a high thoracic disc herniation 10 , and also may occur after anterior cervical spine surgery due to an intraoperative lesion of the cervical sympathetic trunk (CST). Although seen as a minor complication, it can cause relevant concern because blepharoptosis can be disfiguring and can cause visual-field impairment.…”

Horner’s syndrome secondary to T1-T2 intervertebral disc prolapse

“…Bhandutia et al [5] anhidrosis was not seen in our case is unknown. is could be due to incomplete disruption of the sympathetic pathway at the T1 foramen.…”

“…[24,26] e uncommonness of this condition is probably due to the relative stability of the vertebral column at this level. [17] Horner's syndrome in association with T1-T2 IVDP [5,6,11,[13][14][15]20,23,25,27,28] has only been rarely reported. e oculosympathetic pathway consists of central, preganglionic, and postganglionic neurons with two relay centers, the ciliospinal center of Budge and the superior cervical ganglion.…”

“…Among these reported cases of T1-T2 IVDP, we were able to identify Horner's syndrome in only 11 cases (26.2%). [5,6,11,[13][14][15]20,23,25,27,28] [Table 1] summarizes all the 11 cases of T1-T2 IVDP associated with Horner's syndrome published in the literature. e age of these patients ranged from 29 to 60 years.…”

“…ere was a male preponderance. Scapular pain, [15,20,23,27,28] thoracic back pain, [11] upper limb radiculopathy, [5,6,11,[13][14][15]20,23,25,27,28] sensory loss, [5,6,11,15,23,27,28] and weakness of intrinsic muscles of the hand [6,11,13,15,20,23,27] were the presenting symptoms.…”