{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:37:57Z","timestamp":1789799877775,"version":"4.0.1"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Hypoglossal nerve palsy (HNP) is a rare complication after cervical spine surgery and is reported after both anterior and posterior approaches. It often presents with dysarthria, dysphagia, and hoarseness. We present a systematic review of the literature and two cases of patients presenting with confirmed HNP after anterior cervical spine surgery. Methods: Two retrospective case reports and a systematic review of the literature were presented. The electronic databases PubMed and Web of Science were systematically searched from inception. Results: In total, 17 cases of HNP were reported in the literature, including the two hereby presented. Ten cases involved the anterior approach and seven the posterior approach. The reported risk of HNP following cervical spine surgery varied between 0.01% and 2.5% depending on the procedure. The main etiology was mechanical compression of the nerve. Most of the cases recovered within a few months with conservative treatment. In some cases, permanent hypoglossal injury with persistent symptoms was reported. In both of the current cases, the symptoms gradually improved and completely resolved after a few months. Conclusions: HNP is a rare complication after cervical spine surgery. The causes of hypoglossal palsy are multifactorial, but mechanical injury is the most common. A thorough understanding of the nerve\u2019s anatomy is essential to minimize the risk of injury during anesthesia, patient positioning, and surgery. Understanding the underlying mechanisms contributing to HNP post-cervical spine surgery enables the implementation of preventive measures to mitigate its occurrence.<\/jats:p>","DOI":"10.3390\/brainsci15030256","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T04:28:18Z","timestamp":1740716898000},"page":"256","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hypoglossal Nerve Palsy Following Cervical Spine Surgery\u2014Two Case Reports and a Systematic Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"given":"Felicia","family":"Hellquist","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, \u00d6rebro University, 701 82 \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-761X","authenticated-orcid":false,"given":"Victor Gabriel","family":"El-Hajj","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Buwaider","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8781-1169","authenticated-orcid":false,"given":"Erik","family":"Edstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Capio Spine Center Stockholm, L\u00f6wenstr\u00f6mska Hospital, 194 45 Upplands-V\u00e4sby, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3776-6136","authenticated-orcid":false,"given":"Adrian","family":"Elmi-Terander","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, \u00d6rebro University, 701 82 \u00d6rebro, Sweden"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Capio Spine Center Stockholm, L\u00f6wenstr\u00f6mska Hospital, 194 45 Upplands-V\u00e4sby, Sweden"},{"name":"Department of Surgical Sciences, Uppsala University, 753 10 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1053\/j.sult.2022.11.002","article-title":"The hypoglossal nerve","volume":"44","author":"Ventura","year":"2023","journal-title":"Semin. 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