Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass. Case report.
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.
Hong
Jae Taek
JT
Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea.
Lee
Sang Won
SW
Son
Byung Chul
BC
Sung
Jae Hoon
JH
Kim
Il Sub
IS
Park
Chun Kun
CK
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