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Link to original content: http://pubmed.ncbi.nlm.nih.gov/29057361/
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Case Reports
. 2017 Sep;3(3):481-483.
doi: 10.21037/jss.2017.06.19.

Hypoglossal nerve paresis secondary to anterior approach of upper cervical spine followed by spontaneous recovery

Antonio José Vargas López  1 , Laín Hermes González Quarante  1 , Oscar Lucas Gil de Sagredo Del Corral  1 , Antonio Montalvo Afonso  1 , Carlos Fernández Carballal  1
Affiliations
Case Reports

Hypoglossal nerve paresis secondary to anterior approach of upper cervical spine followed by spontaneous recovery

Antonio José Vargas López et al. J Spine Surg. 2017 Sep.

Abstract

We describe an exceptional complication of cervical spine surgery in a 63-year-old male. He suffered the impact of a beam to the top of his head. During evaluation in the emergency room he reported intense neck pain with no other neurological symptoms or findings on physical examination. Spine computed tomography (CT) showed C3 vertebral body fracture that required surgical stabilization. A right side anterior approach to upper cervical spine with C3 corpectomy and placement of iliac bone autograft was performed. After surgery the patient presented dysphagia, dysarthria and limitation tongue mobility to the right side. These findings were consistent with hypoglossal neuropraxia probably related to soft tissue traction generated by the upper part of the self-retaining retractor. After discharge the patient experienced spontaneous improvement of hypoglossal paresis.

Keywords: Spine surgery; anterior approach; complication; hypoglossal nerve injury; upper cervical spine.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Coronal and sagittal view of spine CT showing fracture of C3 vertebral body without invasion of the spinal canal.
Figure 2
Figure 2
Postoperative spine CT image showing proper placement of bone graft, plate and screws.
Figure 3
Figure 3
Comparative photographs showing limitation in mobility of the tongue to the right side.
See this image and copyright information in PMC

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