{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:10:29Z","timestamp":1791875429946,"version":"4.3.4"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Science Research Project of Hebei","award":["20180149\/20230425"],"award-info":[{"award-number":["20180149\/20230425"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Tapia syndrome is a rare complication characterized by concomitant injury to the hypoglossal and vagus nerves, most commonly associated with airway procedures during general anesthesia. Its incidence is extremely low. Literature review reveals that most reported cases involve Tapia syndrome following posterior cervical spine surgery, with no documented cases of Tapia syndrome occurring after open posterior lumbar spine surgery. We report a case of a patient with intradural lumbar disc herniation who underwent routine lumbar PLIF (posterior lumbar interbody fusion) under general anesthesia. The surgery was uneventful with satisfactory clinical outcomes. However, postoperative hoarseness and tongue deviation were observed. Fiberoptic laryngoscopy revealed fixed abduction of the right vocal cord with normal mobility on the left side, suggesting right vocal cord paralysis and leading to a diagnosis of Tapia syndrome. Active management included neurotrophic agents, glucocorticoids, anti-edema medications, and a rehabilitation plan featuring articulation therapy. At the 2-year postoperative follow-up, hoarseness improved by 90%. Although Tapia syndrome following lumbar surgery is extremely rare, enhancing awareness and understanding of this condition is crucial. Particular attention should be given to patients presenting with hoarseness and deviated tongue protrusion after general anesthesia, ensuring timely detection, prompt diagnosis, and early intervention. This rare case (post-lumbar &amp;lt;5 reported) highlights prone positioning risks; vigilant monitoring and early SLP referral essential; conservative management effective in transient cases. This approach helps prevent misdiagnosis and missed diagnosis, thereby minimizing the adverse impact of complications on patients.<\/jats:p>","DOI":"10.3389\/fmed.2026.1802688","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:54:26Z","timestamp":1774421666000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Postoperative Tapia syndrome after lumbar posterior lumbar interbody fusion: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Jinshuai","family":"Zhai","sequence":"first","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Gao","sequence":"additional","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng","family":"Huang","sequence":"additional","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zheng","sequence":"additional","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyi","family":"Li","sequence":"additional","affiliation":[{"name":"The Department of Orthopedics, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1007\/s43390-020-00125-1","article-title":"Tapia\u2019 s syndrome as an uncommon complication after cervical spine surgery with tracheostomy: a case report and literature review","volume":"8","author":"Mega","year":"2020","journal-title":"Spine Deform"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1080\/02688697.2017.1318109","article-title":"Tapia syndrome: an unusual complication following posterior cervical spine surgery","volume":"33","author":"Silva","year":"2019","journal-title":"Br J Neurosurg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1111\/j.1399-6576.2004.00553.x","article-title":"Isolated bilateral paralysis of the hypoglossal and recurrent laryngeal nerves (bilateral Tapia\u2019s syndrome) after transoral 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tracheal intubation general anesthesia","volume":"102","author":"Meng","year":"2022","journal-title":"Natl Med J China"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/ANA.0000000000000443","article-title":"An unusual presentation of Tapia syndrome mimicking a partial Wallenberg syndrome following anterior cervical spine surgery","volume":"30","author":"Kerolus","year":"2018","journal-title":"J Neurosurg Anesthesiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"383","DOI":"10.3760\/cma.j.cn131073.20190806.00333","article-title":"One case of Tapia syndrome after posterior cervical surgery under general anesthesia: literature review","volume":"40","author":"Shi","year":"2020","journal-title":"Chin J Anesthesiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.wneu.2020.05.221","article-title":"Tapia syndrome after cervical laminoplasty: a case report and review of the literature","volume":"141","author":"Waits","year":"2020","journal-title":"World Neurosurg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1745141","DOI":"10.3389\/fsurg.2025.1745141","article-title":"Tapia syndrome following anterior cervical surgery in a patient with diffuse idiopathic skeletal hyperostosis: a case report","volume":"12","author":"Yan","year":"2026","journal-title":"Front Surg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1097\/SCS.0b013e3181c678f0","article-title":"Treatment, classification, and review of Tapia syndrome","volume":"21","author":"Boga","year":"2010","journal-title":"J Craniofac Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"423","DOI":"10.3340\/jkns.2013.54.5.423","article-title":"Tapia\u2019s syndrome after posterior cervical spine surgery under general anesthesia","volume":"54","author":"Park","year":"2013","journal-title":"J Korean Neurosurg Soc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1186\/s13256-022-03632-z","article-title":"Electroacupuncture as an effective therapy for Tapia\u2019s syndrome after transoral intubation for general anesthesia: a case report and review of the literature","volume":"16","author":"Xie","year":"2022","journal-title":"J Med Case Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"401","DOI":"10.3969\/j.issn.2095-9958.2019.06.01","article-title":"Expert consensus on the implementation of enhanced recovery after surgery in posterior short-segment lumbar surgery","volume":"12","author":"Zhang","year":"2019","journal-title":"Chin J Bone Joint Surg"}],"container-title":["Frontiers in 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