Hypoglossal Nerve Palsy After Cervical Spine Surgery

STUDY DESIGN Multi-institutional retrospective study. OBJECTIVE The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. METHODS A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. RESULTS No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy (0.01%). This deficit resolved with conservative management. The rate by institution ranged from 0% to 1.28%. Although not directly injured by the surgical procedure, the transient nerve injury might have been related to patient positioning as has been described previously in the literature. CONCLUSIONS Hypoglossal nerve injury during cervical spine surgery is an extremely rare complication. Institutional rates may vary. Care should be taken during posterior cervical surgery to avoid hyperflexion of the neck and endotracheal tube malposition.