Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass

2006 ◽  
Vol 5 (1) ◽  
pp. 83-85 ◽  
Author(s):  
Jae Taek Hong ◽  
Sang Won Lee ◽  
Byung Chul Son ◽  
Jae Hoon Sung ◽  
Il Sub Kim ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Posterior Instrumentation ◽  
Screw Placement ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Hypoglossal Nerve Palsy ◽  
Atlantoaxial Fixation ◽  
Atlantoaxial Stabilization

✓ 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.

scholarly journals Hypoglossal Nerve Palsy As an Initial Presentation of Glomus Jugulare Tumor in Patient with Breast Cancer: A Case Report and Literature Review

2021 ◽  
Vol 10 ◽  
pp. e2222
Author(s):  
Askar Ghorbani ◽  
Vahid Reza Ostovan
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Clinical Manifestations ◽  
Glomus Jugulare Tumor ◽  
Hypoglossal Nerve Palsy ◽  
Glomus Jugulare ◽  
Work Up

Background: Glomus jugulare tumor is a rare, slow-growing, hyper-vascular paraganglioma that originates from the neural crest derivatives in the wall of the jugular bulb. The most common clinical manifestations of glomus jugulare are pulsatile tinnitus, conductive hearing loss, and hoarseness due to its vascularity and invasion of surrounding structures. Isolated hypoglossal nerve palsy as a presenting feature of the glomus jugulare is very rare. Case Report: We report a 61-year-old woman with a past medical history of breast cancer and diabetic mellitus presenting with progressive difficulty handling food in her mouth and tongue atrophy. Investigations showed skull base lesion and solitary pulmonary nodule. Further work-up led to glomus jugulare and benign solitary pulmonary fibrous tumor diagnosis, although the first impression was metastatic involvement of the jugular foramen. Endovascular embolization of the glomus jugulare was performed, but the patient refused any open surgery due to co-morbidities and the risk of operation. She had no new symptoms at the one-year follow-up, and the size of the lesion became more minor on the follow-up imaging relative to the baseline. Conclusion: Glomus jugulare tumors should be considered and surveyed in the diagnostic work-up of patients with hypoglossal nerve palsy. [GMJ.2021;10:e2222]

Atlantoaxial stabilization with the use of C1–3 lateral mass screw fixation

2006 ◽  
Vol 5 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Eric M. Horn ◽  
Jonathan S. Hott ◽  
Randall W. Porter ◽  
Nicholas Theodore ◽  
Stephen M. Papadopoulos ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Intraoperative Complications ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation ◽  
Cervical Orthosis ◽  
Atlantoaxial Stabilization

✓ Atlantoaxial stabilization has evolved from simple posterior wiring to transarticular screw fixation. In some patients, however, the course of the vertebral artery (VA) through the axis varies, and therefore transarticular screw placement is not always feasible. For these patients, the authors have developed a novel method of atlantoaxial stabilization that does not require axial screws. In this paper, they describe the use of this technique in the first 10 cases. Ten consecutive patients underwent the combined C1–3 lateral mass–sublaminar axis cable fixation technique. The mean age of the patients was 62.6 years (range 23–84 years). There were six men and four women. Eight patients were treated after traumatic atlantoaxial instability developed (four had remote trauma and previous nonunion), whereas in the other two atlantoaxial instability was caused by arthritic degeneration. All had VA anatomy unsuitable to traditional transarticular screw fixation. There were no intraoperative complications in any of the patients. Postoperative computed tomography studies demonstrated excellent screw positioning in each patient. Nine patients were treated postoperatively with the aid of a rigid cervical orthosis. The remaining patient was treated using a halo fixation device. One patient died of respiratory failure 2 months after surgery. Follow-up data (mean follow-up duration 13.1 months) were available for seven of the remaining nine patients and demonstrated a stable construct with fusion in each patient. The authors present an effective alternative method in which C1–3 lateral mass screw fixation is used to treat patients with unfavorable anatomy for atlantoaxial transarticular screw fixation. In this series of 10 patients, the method was a safe and effective way to provide stabilization in these anatomically difficult patients.

Steinmann Pins for C1 Lateral Mass Screw Placement During Atlantoaxial Stabilization

2017 ◽  
Vol 108 ◽  
pp. 560-565
Author(s):  
Joshua E. Meyers ◽  
Kunal Vakharia ◽  
Joseph M. Kowalski ◽  
Vassilios G. Dimopoulos ◽  
John Pollina
Keyword(s):  
Screw Placement ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Atlantoaxial Stabilization ◽  
C1 Lateral Mass Screw

scholarly journals Hypoglossal Nerve Palsy as a Cause of Severe Dysphagia along with the Oropharyngeal Stenosis due to Occipitocervical Kyphosis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Tomohiro Watanabe ◽  
Masato Anno ◽  
Yoshitaka Matsubayashi ◽  
Yuki Nagasako ◽  
Kaori Sakuishi ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Radiographic Examination ◽  
Cervical Kyphosis ◽  
Swallowing Function ◽  
Fusion Surgery ◽  
Hypoglossal Nerve Palsy ◽  
Upper Cervical ◽  
One Year

Hypoglossal nerve palsy (HNP) is a potential cause of dysphagia. A 66-year-old man presented to our hospital with dysphagia and neck pain. One year prior to his first visit, he had been diagnosed with upper cervical tuberculosis and had undergone posterior C1-2 fixation. The physical examination led to the diagnosis of dysphagia with HNP, and he had severe weight loss. Radiographic examination revealed that the O-C kyphosis had been exacerbated and that the deformity was likely the primary cause of HNP. To restore the swallowing function, O-C fusion surgery was performed. Postoperatively, the patient showed immediate improvement of dysphagia with gradual recovery of hypoglossal nerve function. In the last follow-up evaluation, swallowing function was confirmed with no signs of HNP. Our results indicate that HNP could be more prevalent in cases with severe cervical kyphosis, being underdiagnosed due to the more apparent signs of the oropharyngeal narrowing.

Does Transection of the C2 Nerve Roots During C1 Lateral Mass Screw Placement for Atlantoaxial Fixation Result in a Superior Outcome?

Spine ◽  
2017 ◽  
Vol 42 (18) ◽  
pp. E1067-E1076 ◽  
Author(s):  
Jetan H. Badhiwala ◽  
Farshad Nassiri ◽  
Christopher D. Witiw ◽  
Alireza Mansouri ◽  
Saleh A. Almenawer ◽  
...  
Keyword(s):  
Screw Placement ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Nerve Roots ◽  
Atlantoaxial Fixation ◽  
C1 Lateral Mass Screw

scholarly journals Persistent idiopathic unilateral isolated hypoglossal nerve palsy – a report of two cases

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Clement Olesen ◽  
Martin Biilmann Groen ◽  
Jonatan Forsberg ◽  
Ronald Antulov
Keyword(s):  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Hypoglossal Nerve Palsy

Factors affecting lateral mass screw placement at C-7

2011 ◽  
Vol 14 (3) ◽  
pp. 405-411 ◽  
Author(s):  
Kalil G. Abdullah ◽  
Amy S. Nowacki ◽  
Michael P. Steinmetz ◽  
Jeffrey C. Wang ◽  
Thomas E. Mroz
Keyword(s):  
Sagittal Plane ◽  
Anatomical Variation ◽  
Axial Plane ◽  
Screw Placement ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Modified Technique ◽  
Modified Method ◽  
Starting Point ◽  
Lateral Mass Screws

Object The C-7 lateral mass has been considered difficult to fit with instrumentation because of its unique anatomy. Of the methods that exist for placing lateral mass screws, none particularly accommodates this anatomical variation. The authors have related 12 distinct morphological measures of the C-7 lateral mass to the ability to place a lateral mass screw using the Magerl, Roy-Camille, and a modified Roy-Camille method. Methods Using CT scans, the authors performed virtual screw placement of lateral mass screws at the C-7 level in 25 male and 25 female patients. Complications recorded included foraminal and articular process violations, inability to achieve bony purchase, and inability to place a screw longer than 6 mm. Violations were monitored in the coronal, axial, and sagittal planes. The Roy-Camille technique was applied starting directly in the middle of the lateral mass, as defined by Pait's quadrants, with an axial angle of 15° lateral and a sagittal angle of 90°. The Magerl technique was performed by starting in the inferior portion of the top right square of Pait's quadrants and angling 25° laterally in the axial plane with a 45° cephalad angle in the sagittal plane. In a modified method, the starting point is similar to the Magerl technique in the top right square of Pait's quadrant and then angling 15° laterally in the axial plane. In the sagittal plane, a 90° angle is taken perpendicular to the dorsal portion of the lateral mass, as in the traditional Roy-Camille technique. Results Of all the morphological methods analyzed, only a combined measure of intrusion of the T-1 facet and the overall length of the C-7 lateral mass was statistically associated with screw placement, and only in the Roy-Camille technique. Use of the Magerl technique allowed screw placement in 28 patients; use of the Roy-Camille technique allowed placement in 24 patients; and use of the modified technique allowed placement in 46 patients. No screw placement by any method was possible in 4 patients. Conclusions There is only one distinct anatomical ratio that was shown to affect lateral mass screw placement at C-7. This ratio incorporates the overall length of the lateral mass and the amount of space occupied by the T-1 facet at C-7. Based on this virtual study, a modified Roy-Camille technique that utilizes a higher starting point may decrease the complication rate at C-7 by avoiding placement of the lateral mass screw into the T1 facet.

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