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Hypoglossal Nerve Palsy After Cervical Spine Surgery
Christopher P Ames1, Aaron J Clark1, Adam S Kanter2
1University of California, San Francisco, CA, USA.
Global Spine Journal
|April 29, 2017
Summary
Hypoglossal nerve injury is an extremely rare complication of cervical spine surgery, occurring in 0.01% of cases. While glossopharyngeal nerve injuries were not reported, careful patient positioning is crucial to prevent potential nerve damage.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Patient Safety
Background:
- Cervical spine surgery carries risks of rare neurological complications.
- Quantifying the incidence of hypoglossal and glossopharyngeal nerve palsies is important for surgical safety.
Purpose of the Study:
- To determine the incidence of hypoglossal and glossopharyngeal nerve palsies following cervical spine surgery.
- To analyze institutional variations in complication rates.
Main Methods:
- Multi-institutional retrospective study.
- Analysis of 8,887 patients undergoing cervical spine surgery between 2005 and 2011.
- Data collected from 21 participating institutions.
Main Results:
- No cases of glossopharyngeal nerve palsy were reported.
- One case of hypoglossal nerve injury (0.01%) occurred after C3-7 laminectomy, resolving with conservative management.
- Institutional incidence rates ranged from 0% to 1.28%.
Conclusions:
- Hypoglossal nerve injury is an exceedingly rare complication of cervical spine surgery.
- Patient positioning, particularly avoiding neck hyperflexion and endotracheal tube malposition during posterior approaches, is critical.
- Surgeons should be vigilant for potential nerve injuries and institutional rates may differ.
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