Clin Orthop Surg.  2012 Mar;4(1):77-82. 10.4055/cios.2012.4.1.77.

Efficacy of Postoperative Radiograph for Evaluating the Prevertebral Soft Tissue Swelling after Anterior Cervical Discectomy and Fusion

Affiliations
  • 1Department of Orthopedic Surgery, Chonbuk National University Hospital, Jeonju, Korea.
  • 2Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea. alla1013@naver.com

Abstract

BACKGROUND
After surgery for degenerative spinal disease by the anterior approach, the degree of soft tissue swelling can be assessed simply using plain radiographs. However, there are little studies according to the surgical methods or extent of surgery, and no study had addressed the clinical meaning of swelling determined by plain radiography. The purpose of this study was to evaluate the clinical significance of prevertebral soft tissue swelling (PSTS) after anterior cervical fusion with plate fixation for the treatment of degenerative cervical spinal disorders.
METHODS
One hundred and thirty-five patients that underwent anterior cervical fusion with plate augmentation for degenerative cervical spondylosis were included in this study. PSTS differences were analyzed with respect to numbers of fusion segments and location of fusion. Cases were divided into two groups based on the amount of PSTS, and incidences of dyspnea, dysphagia, dysphonia were evaluated.
RESULTS
PSTS increments were significantly greater in patients that had undergone multi-level or high-level fusion. Complications of dyspnea, dysphagia and dysphonia were found more frequently in patients with marked PSTS group.
CONCLUSIONS
Increments of PSTS after anterior cervical fusion for degenerative spinal disorders are greater and incidences of complications are higher in patients that undergo multi-level or high-level fusion. Thus, measurement of PSTS using consecutive cervical lateral radiographs after anterior cervical surgery is clinically meaningful procedure.

Keyword

Cervical spine; Prevertebral soft tissue swelling; Anterior cervical discectomy and fusion

MeSH Terms

Adult
Aged
Aged, 80 and over
Cervical Vertebrae/surgery
Deglutition Disorders/etiology
Diskectomy/*adverse effects
Dysphonia/etiology
Dyspnea/etiology
Edema/etiology/*radiography
Female
Humans
Male
Middle Aged
Neck Injuries/etiology/*radiography
Soft Tissue Injuries/etiology/*radiography
Spinal Fusion/*adverse effects
Spondylosis/*surgery

Figure

  • Fig. 1 Measurement method of prevertebral soft tissue swelling. The prevertebral soft tissue was measured between the anterior surface of each vertebral body and the air shadow of the airway.

  • Fig. 2 The histogram shows the time course of prevertebral soft tissue swelling (mm) in the postoperative period. Postop: operation day, POD1: day 1 after operation, POD2: day 2 after operation, POD3: day 3 after operation, POD4: day 4 after operation, POD5: day 5 after operation.


Cited by  3 articles

Analysis of the Risk Factors Associated with Prolonged Intubation or Reintubation after Anterior Cervical Spine Surgery
Moinay Kim, Seung Chul Rhim, Sung Woo Roh, Sang Ryong Jeon
J Korean Med Sci. 2018;33(17):.    doi: 10.3346/jkms.2018.33.e77.

The Efficacy of Carotid Tubercle as an Anatomical Landmark for Identification of Cervical Spinal Level in the Anterior Cervical Surgery: Comparison with Preoperative C-arm Fluoroscopy
Jae Hyup Lee, Ji-Ho Lee, Hyeong-Seok Lee, Do-Yoon Lee, Dong-Oh Lee
Clin Orthop Surg. 2013;5(2):129-133.    doi: 10.4055/cios.2013.5.2.129.

Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion
Doo Kyung Son, Dong Wuk Son, Ho Sang Kim, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
J Korean Neurosurg Soc. 2014;56(2):103-107.    doi: 10.3340/jkns.2014.56.2.103.


Reference

1. Weir DC. Roentgenographic signs of cervical injury. Clin Orthop Relat Res. 1975. (109):9–17.
Article
2. Chong VF, Fan YF. Radiology of the retropharyngeal space. Clin Radiol. 2000. 55(10):740–748.
Article
3. Boucher C, Dorion D, Fisch C. Retropharyngeal abscesses: a clinical and radiologic correlation. J Otolaryngol. 1999. 28(3):134–137.
4. Templeton PA, Young JW, Mirvis SE, Buddemeyer EU. The value of retropharyngeal soft tissue measurements in trauma of the adult cervical spine: cervical spine soft tissue measurements. Skeletal Radiol. 1987. 16(2):98–104.
Article
5. Miles KA, Maimaris C, Finlay D, Barnes MR. The incidence and prognostic significance of radiological abnormalities in soft tissue injuries to the cervical spine. Skeletal Radiol. 1988. 17(7):493–496.
Article
6. Keats TE, editor. Emergency radiology. 1989. 2nd ed. St Louis: Year Book Medical Publishers.
7. Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958. 40(3):607–624.
Article
8. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976). 2002. 27(22):2453–2458.
9. Schwartz SR, Cohen SM, Dailey SH, et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2009. 141:3 Suppl 2. S1–S31.
10. Sanfilippo JA Jr, Lim MR, Jacoby SM, et al. "Normal" prevertebral soft tissue swelling following elective anterior cervical decompression and fusion. J Spinal Disord Tech. 2006. 19(6):399–401.
Article
11. Suk KS, Kim KT, Lee SH, Park SW. Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixation. Int Orthop. 2006. 30(4):290–294.
Article
12. Suk KS, Kim KT, Lee JH, Lee SH, Kim JS, Choi IH. Prevertebral soft tissue swelling after anterior cervical discectomy and fusion: comparison between plate fixation and cage insertion. J Korean Orthop Assoc. 2009. 44(2):249–255.
Article
13. Andrew SA, Sidhu KS. Airway changes after anterior cervical discectomy and fusion. J Spinal Disord Tech. 2007. 20(8):577–581.
Article
14. Epstein NE, Hollingsworth R, Nardi D, Singer J. Can airway complications following multilevel anterior cervical surgery be avoided. J Neurosurg. 2001. 94:2 Suppl. 185–188.
Article
15. Sagi HC, Beutler W, Carroll E, Connolly PJ. Airway complications associated with surgery on the anterior cervical spine. Spine (Phila Pa 1976). 2002. 27(9):949–953.
Article
16. Emery SE, Smith MD, Bohlman HH. Upper-airway obstruction after multilevel cervical corpectomy for myelopathy. J Bone Joint Surg Am. 1991. 73(4):544–551.
Article
17. Frempong-Boadu A, Houten JK, Osborn B, et al. Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech. 2002. 15(5):362–368.
Article
18. Martin RE, Neary MA, Diamant NE. Dysphagia following anterior cervical spine surgery. Dysphagia. 1997. 12(1):2–8.
Article
19. Winslow CP, Winslow TJ, Wax MK. Dysphonia and dysphagia following the anterior approach to the cervical spine. Arch Otolaryngol Head Neck Surg. 2001. 127(1):51–55.
Article
20. Riley LH 3rd, Skolasky RL, Albert TJ, Vaccaro AR, Heller JG. Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study. Spine (Phila Pa 1976). 2005. 30(22):2564–2569.
21. Fogel GR, McDonnell MF. Surgical treatment of dysphagia after anterior cervical interbody fusion. Spine J. 2005. 5(2):140–144.
Article
22. Seidl RO, Todt I, Ernst A. Esophagus atresia after cervical spine surgery: case report and literature review. Eur Arch Otorhinolaryngol. 2007. 264(3):291–293.
Article
Full Text Links
  • CIOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr