An unexpected complication of occipitocervical stabilization surgery: retropharyngeal hematoma

Background context

To report a unique case of an unexpected complication of occipitocervical stabilization surgery that is retropharyngeal hematoma (RH).

Purpose

Postoperative RH is a very rare complication and has never been reported after posterior occipitocervical surgery.

Study design

Case report.

Methods

A 44-year-old woman being treated for rheumatoid arthritis for 20 years was admitted to our hospital in a wheelchair with the complaints of neck pain and weakness in both upper and lower extremities. She was diagnosed with basilar invagination, and occipitocervical (C0–C5) transpedicular fixation with osteosynthesis using iliac autograft was performed. The airway was seen as obstructed after extubation. The airway was maintained with laryngeal mask, and computed tomography revealed an RH. Emergent tracheotomy was performed. The patient was decannulated because of the resorption of RH after 10 days and was discharged.

Conclusion

This patient is the first patient, to our knowledge, to be reported for unexplained RH after cervical posterior spinal surgery.