颈椎手术后的舌下神经麻痹
Hypoglossal Nerve Palsy After Cervical Spine Surgery.
作者信息
Ames Christopher P, Clark Aaron J, Kanter Adam S, Arnold Paul M, Fehlings Michael G, Mroz Thomas E, Riew K Daniel
机构信息
University of California, San Francisco, CA, USA.
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
出版信息
Global Spine J. 2017 Apr;7(1 Suppl):37S-39S. doi: 10.1177/2192568216687307. Epub 2017 Apr 1.
STUDY DESIGN
Multi-institutional retrospective study.
OBJECTIVE
The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies.
METHODS
A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions.
RESULTS
No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy (0.01%). This deficit resolved with conservative management. The rate by institution ranged from 0% to 1.28%. Although not directly injured by the surgical procedure, the transient nerve injury might have been related to patient positioning as has been described previously in the literature.
CONCLUSIONS
Hypoglossal nerve injury during cervical spine surgery is an extremely rare complication. Institutional rates may vary. Care should be taken during posterior cervical surgery to avoid hyperflexion of the neck and endotracheal tube malposition.
研究设计
多机构回顾性研究。
目的
本研究的目的是量化颈椎手术两种极其罕见并发症的发生率；舌下神经和舌咽神经麻痹。
方法
本研究纳入了2005年至2011年期间在21家机构接受颈椎手术的8887例患者。
结果
未报告舌咽神经损伤。1例舌下神经损伤发生在C3 - 7椎板切除术后（0.01%）。该功能障碍经保守治疗后缓解。各机构的发生率在0%至1.28%之间。虽然手术过程中未直接损伤，但短暂性神经损伤可能与患者体位有关，如先前文献所述。
结论
颈椎手术期间舌下神经损伤是一种极其罕见的并发症。各机构的发生率可能有所不同。颈椎后路手术时应注意避免颈部过度屈曲和气管插管位置不当。
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