Vargas López Antonio José, González Quarante Laín Hermes, Gil de Sagredo Del Corral Oscar Lucas, Montalvo Afonso Antonio, Fernández Carballal Carlos
Neurological Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
J Spine Surg. 2017 Sep;3(3):481-483. doi: 10.21037/jss.2017.06.19.
We describe an exceptional complication of cervical spine surgery in a 63-year-old male. He suffered the impact of a beam to the top of his head. During evaluation in the emergency room he reported intense neck pain with no other neurological symptoms or findings on physical examination. Spine computed tomography (CT) showed C3 vertebral body fracture that required surgical stabilization. A right side anterior approach to upper cervical spine with C3 corpectomy and placement of iliac bone autograft was performed. After surgery the patient presented dysphagia, dysarthria and limitation tongue mobility to the right side. These findings were consistent with hypoglossal neuropraxia probably related to soft tissue traction generated by the upper part of the self-retaining retractor. After discharge the patient experienced spontaneous improvement of hypoglossal paresis.
我们描述了一名63岁男性颈椎手术的罕见并发症。他头部顶部受到横梁撞击。在急诊室评估期间,他报告颈部剧痛,体格检查未发现其他神经症状或体征。脊柱计算机断层扫描(CT)显示C3椎体骨折,需要手术固定。采用右侧前路入路上颈椎,行C3椎体次全切除并植入自体髂骨。术后患者出现吞咽困难、构音障碍和右侧舌活动受限。这些表现与舌下神经失用症一致,可能与自持牵开器上部产生的软组织牵拉有关。出院后患者舌下神经麻痹自发改善。