Postoperative Blindness Following Posterior Cervical Surgery: Case Reports

Posterior cervical surgery blindness (PCSB) is a rare but serious complication with significant implications for affected patients. Herein, we retrospectively analyzed two cases of postoperative blindness. Case 1: A 51-year-old with basilar invagination, atlantoaxial dislocation, and syringomyelia. Blindness, caused by central retinal artery occlusion, occurred after atlantoaxial decompression and fusion in the prone position. After the arterial thrombolytic therapy, the vision gradually improved. Case 2: A 58-year-old with radiculopathy-type cervical spondylosis. Blindness, caused by vitreous hemorrhage, occurred after dual-channel endoscopic cervical disc nucleotomy in the prone position. Vision did not recover after 1 year. PCSB is linked to the prone position and use of a horseshoe headrest. Early intra-arterial thrombolysis can significantly promote visual recovery. Preoperative counseling, careful intraoperative management, and active postoperative care are essential to reducing the risk.