Citation: Global Spine Journal. 7(1 Suppl):103S-108S, 2017 Apr.Journal: Global spine journal.Published: 2017ISSN: 2192-5682.Full author list: Traynelis VC; Malone HR; Smith ZA; Hsu WK; Kanter AS; Qureshi SA; Cho SK; Baird EO; Isaacs RE; Rahman RK; Polevaya G; Smith JS; Shaffrey C; Tortolani PJ; Stroh DA; Arnold PM; Fehlings MG; Mroz TE; Riew KD.UI/PMID: 28451480.Subject(s): PubMed-not-MEDLINE -- Not indexedInstitution(s): Medstar Union Memorial HospitalActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1177/2192568216688184 (Click here)Abbreviated citation: Global spine j.. 7(1 Suppl):103S-108S, 2017 Apr.Abstract: STUDY DESIGN: A multicenter retrospective case series.Abstract: OBJECTIVE: Horner's syndrome is a known complication of anterior cervical spinal surgery, but it is rarely encountered in clinical practice. To better understand the incidence, risks, and neurologic outcomes associated with Horner's syndrome, a multicenter study was performed to review a large collective experience with this rare complication.Abstract: METHODS: We conducted a retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17625 patients who received subaxial cervical spine surgery from 2005 to 2011 were reviewed to identify occurrence of 21 predefined treatment complications. Descriptive statistics were provided for baseline patient characteristics. Paired t test was used to analyze changes in clinical outcomes at follow-up compared to preoperative status.Abstract: RESULTS: In total, 8887 patients who underwent anterior cervical spine surgery at the participating institutions were screened. Postoperative Horner's syndrome was identified in 5 (0.06%) patients. All patients experienced the complication following anterior cervical discectomy and fusion. The sympathetic trunk appeared to be more vulnerable when operating on midcervical levels (C5, C6), and most patients experienced at least a partial recovery without further treatment.Abstract: CONCLUSIONS: This collective experience suggests that Horner's syndrome is an exceedingly rare complication following anterior cervical spine surgery. Injury to the sympathetic trunk may be limited by maintaining a midline surgical trajectory when possible, and performing careful dissection and retraction of the longus colli muscle when lateral exposure is necessary, especially at caudal cervical levels.