Hypoglossal nerve injury with C1 lateral mass screw placement: A case report and review of the literature.
Publication/Presentation Date
12-1-2022
Abstract
We report the case of a 62-year-old man who presented with a progressive myelopathy secondary to spinal cord compression from an odontoid process fracture and subaxial central canal stenosis. The patient underwent a C1-T2 posterior decompression and instrumented fusion (PCDF) and did well immediately postoperatively. However, on POD1, he developed a right hypoglossal nerve (HN) palsy attributed to direct mechanical compression or injury from the C1 lateral mass screw (LMS), which improved following a revision and screw replacement. While HN injury is a known complication of high anterior and anterolateral cervical spine approaches as well as transcondylar screw fixation, this case aims to expand on the limited reports available regarding hypoglossal nerve injury following placement of bicortical C1 LMS. Furthermore, the use of fluoroscopic guidance in addition to anatomic landmarks and triggered electromyography of the tongue are offered as potential solutions to prevent HN injury intraoperatively.
Volume
17
Issue
12
First Page
4594
Last Page
4598
ISSN
1930-0433
Published In/Presented At
De Abreu Pineda, M., Atallah, E., Wainwright, J., Schaefer, J., Mahtabfar, A., Harrop, J., Prasad, S., Heller, J., Sharan, A., Sivaganesan, A., & Jallo, J. (2022). Hypoglossal nerve injury with C1 lateral mass screw placement: A case report and review of the literature. Radiology case reports, 17(12), 4594–4598. https://doi.org/10.1016/j.radcr.2022.09.006
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
36193267
Department(s)
Administration and Leadership
Document Type
Article