Hypoglossal nerve paresis secondary to anterior approach of upper cervical spine followed by spontaneous recovery
We describe an exceptional complication of cervical spine surgery in a 63-year-old male. He suffered the impact of a beam on the top of his head. During evaluation in emergency room he presented intense neck pain with no other neurological symptoms or findings in physical examination. Spine 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 in mobility of the tongue to the right side. These findings were consistent to 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.