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C1 Lateral Mass Screw Migration Causing a Delayed Unilateral Hypoglossal Nerve Lesion: A Case Report
Douglas Hollern1, Karim Shafi2, Andrew Miller2
1The Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, Pennsylvania.
Case:
We present the case of a fifty-eight-year-old woman who was initially treated with a C1 to C7 anterior-posterior cervical decompression and fusion for an epidural abscess and returned two years postoperatively with four days of progressive dysphagia and tongue deviation. She was diagnosed with a unilateral hypoglossal nerve (cranial nerve XII) palsy secondary to compression from a C1 lateral mass screw.
Conclusion:
This is the first reported case that we are aware of describing a delayed cranial nerve palsy secondary to cutout and cephalad migration of a C1 lateral mass screw resulting in a neurologic deficit due to impingement on the hypoglossal nerve.
