Department of Neurosurgery, Mie Chuo Medical Center, Tsu, Mie, Japan.
Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Br J Neurosurg. 2020 Oct;34(5):508-511. doi: 10.1080/02688697.2018.1538485. Epub 2018 Nov 19.
Although dysphagia is known potential complication of cervical spine surgery, it rarely occurs after a posterior approach. We describe an unusual case of a retro-odontoid pseudotumor that suffered dysphagia following a C1 laminectomy and posterior atlantoaxial fixation. A 79-year-old man presented with progressive tetraparesis and bladder and bowel dysfunction due to severe compression to cervical cord at C1 from a retro-odontoid pseudotumor. After C1 laminectomy and atlantoaxial fixation, the symptoms improved, but dysphagia and aspiration developed, associated with pharyngeal and esophageal stases on videofluoroscopy. Possible explanations for postoperative dysphagia include limitation of cervical spine motion, and cervical cord reperfusion injury in addition to the baseline anterior osteophyte and aging. This is the first case of dysphagia developing after laminectomy and posterior atlantoaxial fixation not involving the occipital bone.
尽管吞咽困难是颈椎手术已知的潜在并发症，但它很少在后路手术中发生。我们描述了一例不常见的寰椎齿状突后假瘤病例，该患者在接受 C1 椎板切除术和后路寰枢固定术后出现吞咽困难。一名 79 岁男性因颈 1 段齿状突后假瘤严重压迫颈髓而出现进行性四肢瘫痪和膀胱、肠道功能障碍。在接受 C1 椎板切除术和寰枢固定术后，症状改善，但出现吞咽困难和误吸，视频透视检查显示咽和食管停滞。术后吞咽困难的可能解释包括颈椎运动受限、颈髓再灌注损伤以及基线前骨赘和老化。这是首例不涉及枕骨的后路寰枢固定术后发生的吞咽困难病例。
