Journal
JOURNAL OF NEUROSURGERY-SPINE
Volume 5, Issue 1, Pages 83-85Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/spi.2006.5.1.83
Keywords
atlantoaxial fixation; lateral mass screw; hypoglossal nerve palsy
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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.
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