Vision Loss Following Vertebral Artery Injury during Surgery for Atlantoaxial Instability

Neurol India. 2022 Sep-Oct;70(Supplement):S144-S148. doi: 10.4103/0028-3886.360938.

Abstract

Background: A number of complications following surgery aimed at atlantoaxial fixation have been reported. However, there is no report in the literature describing visual loss following vertebral artery injury.

Objective: Vision loss as a complication of vertebral artery injury during surgery for atlantoaxial fixation is reported.

Material and methods: This is a report of two patients who were operated for atlantoaxial instability by the Goel technique of atlantoaxial fixation. During surgery, there was an injury to the vertebral artery and the artery had to be sacrificed.

Results: Both patients suffered severe visual loss following surgery. One patient had a partial visual recovery that started within few days of surgery while the other patient remained completely blind.

Conclusions: Although rare, visual loss can be a complication of vertebral artery sacrifice during surgery for atlantoaxial stabilization.

Keywords: Atlantoaxial instability; Goel technique; Magerl technique; vertebral artery.

MeSH terms

  • Atlanto-Axial Joint* / diagnostic imaging
  • Atlanto-Axial Joint* / injuries
  • Atlanto-Axial Joint* / surgery
  • Blindness / etiology
  • Bone Screws
  • Craniocerebral Trauma / complications
  • Humans
  • Joint Instability* / etiology
  • Joint Instability* / surgery
  • Neck Injuries / complications
  • Neck Injuries / surgery
  • Spinal Diseases / etiology
  • Spinal Diseases / surgery
  • Spinal Fusion* / adverse effects
  • Spinal Fusion* / methods
  • Vascular System Injuries* / etiology
  • Vertebral Artery* / diagnostic imaging
  • Vertebral Artery* / injuries
  • Vertebral Artery* / surgery
  • Vision Disorders* / etiology