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C1 Lateral Mass Screw Migration Causing a Delayed Unilateral Hypoglossal Nerve Lesion

A Case Report

Hollern, Douglas, MD1,a; Shafi, Karim, BS2; Miller, Andrew, MD2; Woods, Barrett, MD1,2; Heller, Joshua, MD3; Vaccaro, Alexander, MD, PhD1-3,,

doi: 10.2106/JBJS.CC.O.00168
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Disclosures

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.

1The Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, Pennsylvania

2Department of Orthopaedic Surgery, Thomas Jefferson Sidney Kimmel Medical College, Philadelphia, Pennsylvania

3Department of Neurological Surgery, Thomas Jefferson Sidney Kimmel Medical College, Philadelphia, Pennsylvania

aE-mail address for D. Hollern: Doughollern@gmail.com

Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated
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