title: Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass. Case report.
abstract: Atlantoaxial fixation in which C1-2 screw-rod fixation is performed is a relatively new method. Because reports about this technique are rather scant, little is known about its associated complications. In this report the authors introduce hypoglossal nerve palsy as a complication of this novel posterior atlantoaxial stabilization method. A 67-year-old man underwent a C1-2 screw-rod fixation for persistent neck pain resulting from a Type 2 odontoid fracture that involved disruption of the transverse atlantal ligament. Posterior instrumentation in which a C-1 lateral mass screw and C-2 pedicle screw were placed was performed. Postoperatively, the patient suffered dysphagia with deviation of the tongue to the left side. At the 4-month follow-up examination, bone fusion was noted on plain x-ray studies of the cervical spine. His hypoglossal nerve palsy resolved completely 2 months postoperatively. To the authors' knowledge, this is the first report in the literature of hypoglossal nerve palsy following C1-2 screw-rod fixation. The hypoglossal nerve is one of the structures that can be damaged during C-1 lateral mass screw placement.
authors.affiliation: Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea.
authors.forename: Jae Taek
authors.initials: JT
authors.lastname: Hong
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Son
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Sung
authors.forename: Il Sub
authors.initials: IS
authors.lastname: Kim
authors.forename: Chun Kun
authors.initials: CK
authors.lastname: Park
mesh_terms: D000368:Aged; D001863:Bone Screws / Q000009:adverse effects*; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000209:etiology*; D008297:Male; D009809:Odontoid Process / Q000293:injuries*; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation