Computed tomography-based investigation of degenerative neural cervicothoracic foraminal stenosis as a potential mechanism for Horner syndrome.

Frontiers in ophthalmology Pub Date : 2025-01-07 eCollection Date: 2024-01-01 DOI:10.3389/fopht.2024.1497845
Joshua Ong, Mariko Kurokawa, Sangeeta Khanna, Lindsey B De Lott, Ryo Kurokawa, Aseem Sharma
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Abstract

Purpose: To investigate the presence and/or severity of cervicothoracic foraminal stenosis between the C7 and T3 segments could account for Horner syndrome, otherwise deemed to be idiopathic in nature.

Methods: This study was an IRB-approved, retrospective study that included 28 patients [mean ± standard deviation (age: 54.5 ± 18.7 years)] with a confirmed diagnosis of Horner syndrome, absence of any identifiable cause, and availability of a neck CT/CT angiogram obtained within 6 months of the diagnosis. A neuroradiologist masked to the laterality of Horner syndrome reviewed the CT scans, documenting the presence/severity of foraminal stenosis at levels C7-T1, T1-2, and T2-3 on a 4-point Likert scale defined as follows: 0, none; 1, mild; 2, moderate; and 3, severe narrowing, with grades 1, 2, and 3 signifying <1/3rd, 1/3rd-2/3rd, and >2/3rd stenosis of the expected normal foraminal dimension.

Results: Foraminal stenosis was present ipsilateral to the side of Horner syndrome in four (14.3%) patients and on the contralateral side in five (17.8%) patients. No significant difference in the extent of ipsilateral and contralateral foraminal stenosis was present at C7-T1 (p = 0.66), T1-2 (p = 0.32), or T2-3 (p = 0.75) levels. Mean ipsilateral (0.33 ± 1.0) and contralateral (0.33 ± 1.1) cumulative foraminal stenosis ddddscores were not significantly different (p = 1). Mean maximum foraminal stenosis scores ipsilateral (0.22 ± 0.59) and contralateral (0.30 ± 0.81) to the side of Horner syndrome were also comparable (p = 0.54).

Conclusion: With the low prevalence of foraminal stenosis at C7-T3 segments and the equivalent prevalence and severity of foraminal stenosis ipsilateral and contralateral to the side of Horner syndrome, foraminal stenosis is unlikely to be a common causative mechanism for Horner syndrome.

基于计算机断层扫描的退行性神经性颈胸椎间孔狭窄作为Horner综合征的潜在机制的研究。
目的:探讨C7和T3节段之间颈胸椎间孔狭窄的存在和/或严重程度可能导致Horner综合征,否则被认为是特发性的。方法:本研究是一项经irb批准的回顾性研究,纳入了28例确诊为Horner综合征的患者[平均±标准差(年龄:54.5±18.7岁)],没有任何可识别的病因,并在诊断后6个月内获得颈部CT/CT血管造影。一位不知道Horner综合征侧侧性的神经放射学家检查了CT扫描,记录了C7-T1、T1-2和T2-3椎间孔狭窄的存在/严重程度,李克特评分为4分,定义如下:0,无;1、温和;2、温和;3级,严重狭窄,1级、2级和3级,表示正常椎间孔尺寸的2/3狭窄。结果:Horner综合征患者椎间孔狭窄4例(14.3%)发生在同侧,5例(17.8%)发生在对侧。在C7-T1 (p = 0.66)、T1-2 (p = 0.32)和T2-3 (p = 0.75)水平上,同侧和对侧椎间孔狭窄程度无显著差异。平均同侧(0.33±1.0)和对侧(0.33±1.1)椎间孔狭窄累积评分无显著差异(p = 1)。平均最大椎间孔狭窄累积评分同侧(0.22±0.59)和对侧(0.30±0.81)Horner综合征侧也具有可比性(p = 0.54)。结论:C7-T3节段椎间孔狭窄发生率较低,与Horner综合征同侧和对侧椎间孔狭窄发生率和严重程度相当,椎间孔狭窄不太可能是Horner综合征的常见病因机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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