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Case Reports
. 2017 Jan-Mar;7(1):e4.
doi: 10.2106/JBJS.CC.16.00106.

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

Amit K Bhandutia  1 , Zachary Zuzek  2 , Matthew J Schessler  1 , Nestor D Tomycz  1 , Daniel T Altman  1
Affiliations
Case Reports

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

Amit K Bhandutia et al. JBJS Case Connect. 2017 Jan-Mar.

Abstract

Case: A 29-year-old man presented with right medial arm pain with paresthesia, as well as right-sided ptosis, miosis, and anhidrosis. Magnetic resonance imaging revealed a right paracentral disc herniation at the T1-T2 level. The patient underwent a hemilaminectomy with a medial facetectomy through a posterolateral approach to the T1-T2 disc space, followed by a discectomy. Intraoperative findings were notable for a conjoined nerve root.

Conclusion: 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.

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