Hellquist Felicia, El-Hajj Victor Gabriel, Buwaider Ali, Edström Erik, Elmi-Terander Adrian
Department of Medical Sciences, Örebro University, 701 82 Örebro, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
Brain Sci. 2025 Feb 27;15(3):256. doi: 10.3390/brainsci15030256.
BACKGROUND/OBJECTIVES: Hypoglossal nerve palsy (HNP) is a rare complication after cervical spine surgery and is reported after both anterior and posterior approaches. It often presents with dysarthria, dysphagia, and hoarseness. We present a systematic review of the literature and two cases of patients presenting with confirmed HNP after anterior cervical spine surgery.
Two retrospective case reports and a systematic review of the literature were presented. The electronic databases PubMed and Web of Science were systematically searched from inception.
In total, 17 cases of HNP were reported in the literature, including the two hereby presented. Ten cases involved the anterior approach and seven the posterior approach. The reported risk of HNP following cervical spine surgery varied between 0.01% and 2.5% depending on the procedure. The main etiology was mechanical compression of the nerve. Most of the cases recovered within a few months with conservative treatment. In some cases, permanent hypoglossal injury with persistent symptoms was reported. In both of the current cases, the symptoms gradually improved and completely resolved after a few months.
HNP is a rare complication after cervical spine surgery. The causes of hypoglossal palsy are multifactorial, but mechanical injury is the most common. A thorough understanding of the nerve's anatomy is essential to minimize the risk of injury during anesthesia, patient positioning, and surgery. Understanding the underlying mechanisms contributing to HNP post-cervical spine surgery enables the implementation of preventive measures to mitigate its occurrence.
背景/目的：舌下神经麻痹（HNP）是颈椎手术后一种罕见的并发症，在前路和后路手术后均有报道。它常表现为构音障碍、吞咽困难和声音嘶哑。我们对文献进行了系统回顾，并报告两例颈椎前路手术后确诊为HNP的患者。
呈现了两篇回顾性病例报告及对文献的系统回顾。从数据库建立起就对电子数据库PubMed和Web of Science进行了系统检索。
文献中共报道了17例HNP，包括本文所呈现的两例。其中10例涉及前路手术，7例涉及后路手术。根据手术方式不同，颈椎手术后HNP的报道发生率在0.01%至2.5%之间。主要病因是神经的机械性压迫。大多数病例经保守治疗在数月内恢复。在一些病例中，报道出现了伴有持续症状的永久性舌下神经损伤。在当前这两例中，症状逐渐改善并在数月后完全缓解。
HNP是颈椎手术后一种罕见的并发症。舌下神经麻痹的病因是多因素的，但机械性损伤是最常见的。全面了解神经解剖结构对于在麻醉、患者体位摆放和手术过程中降低损伤风险至关重要。了解颈椎手术后导致HNP的潜在机制有助于实施预防措施以减少其发生。
