C1–2 facet disarticulation for correction of iatrogenic cervical kyphosis following occipital-cervical fusion
C1–2 facet disarticulation for correction of iatrogenic cervical kyphosis following occipital-cervical fusion
Miki Katzir, MD, Aboubakr T. Amer, MD, Asad S. Akhter, MD, Stephanus V. Viljoen, MD, and Ehud Mendel, MD, MBA
Department of Neurological Surgery and the James Cancer Hospital, Wexner Medical Center, The Ohio State University, Columbus, Ohio
The patient is a 69-year-old woman with a history of atlantoaxial instability and cervical pain who underwent an occipital-cervical fusion at an outside hospital. Five days following the procedure she required a PEG tube due to progressive dysphagia. Compared with preoperative imaging, x-ray shows cervical spine hyperextension with a significant decrease in the occipital–C2 angle. A swallow test confirmed aspiration and pharyngeal phase functional impairment. Two-stage surgery consisted of hardware removal, drilling the fused right C1–2 facet, reinstrumentation, and halo placement. The swallowing test confirmed there is no aspiration. We proceeded with rod placement. The patient recovered completely.
10.3171/2020.4.FocusVid.20175