Development of dysphagia and trismus developed after c1-2 posterior fusion in extended position

Haruo Misawa, Masato Tanaka, Yoshihisa Sugimoto, Kouichiro Koshimune, Toshifumi Ozaki

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Cervical misalignment after upper cervical fusion including the occipital bone may cause trismus or dysphagia, because the occipito-atlanto joint is associated with most of the flex and extended motion of the cervical spine. There are no reports of dysphagia and trismus after Cl-2 fusion. The purpose of this paper is to demonstrate the potential risk of dysphagia and trismus even after upper cervical short fusion without the occipital bone. The patient was a 69-year-old man with myelopathy caused by os odontoideum and Klippel-Feil syndrome, who developed dysphagia and trismus immediately after Cl-2 fusion and C3-6 laminoplasty. Radiographs and CT revealed that his neck posture was extended, but his symptoms still existed a week after surgery. The fixation angle was hyperextended 12 days after the first surgery. His symptoms disappeared immediately after revision surgery. The fixation in the neck-flexed position is thought to be the main cause of the patient's post-operative dysphagia and tris-mus. Dysphagia and trismus may occur even after short upper cervical fusion without the occipital bone or cervical fusion in the neck-extended position. The pre-operative cervical alignment and range of motion of each segment should be thoroughly evaluated.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalActa medica Okayama
Issue number3
Publication statusPublished - 2013


  • Atlantoaxial posterior fusion
  • Klippel-Feil syndrome
  • Os odontoid
  • Trismus
  • dysphagia

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology


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