J Korean Orthop Assoc.  2013 Oct;48(5):407-411. 10.4055/jkoa.2013.48.5.407.

Acute Respiratory Distress Due to Delayed Hematoma after Anterior Cervical Discectomy Fusion

• Song KJ
• Lee SK
• Lee KB

• KMID: 1494155
• DOI: http://doi.org/10.4055/jkoa.2013.48.5.407

Abstract

Hematoma resulting in acute respiratory distress associated with anterior cervical spine surgery is rare; however, it is a serious adverse complication and occurs primarily within postoperative three days and is cured in the hospital. Rarely, delayed hematoma occurs after discharge from the hospital, and treatment of respiration is difficult. In this review, we report on a case of acute respiratory distress due to delayed hematoma following anterior cervical discectomy and fusion, which occurred at postoperative five days.

Keyword

anterior cervical discectomy and fusion; hematoma; acute respiratory distress

MeSH Terms

Diskectomy*
Hematoma*
Respiration
Spine

Figure

• 

  Figure 1 (A) Lateral cervical spine radiograph on the operative day shows mild swelling in the prevertebral area. (B) Lateral radiograph at postoperative five days shows no difference of prevertebral swelling. long arrow: C5, short arrow: C7.

• 

  Figure 2 Lateral radiograph shows severe prevertebral swelling with acute respiratory difficulty.

• 

  Figure 3 (A) Computed tomography axial scan shows a massive hematoma at the C7 area, which pushes the trachea to the right. (B) Sagittal scan shows that the hematoma was located in the entire cervical spine area.

• 

  Figure 4 Lateral radiograph shows a decreased amount of swelling, which was compared with that taken during respiration distress.

Reference

1. Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 2007; 32:2310–2317.

2. Wang MC, Chan L, Maiman DJ, Kreuter W, Deyo RA. Complications and mortality associated with cervical spine surgery for degenerative disease in the United States. Spine (Phila Pa 1976). 2007; 32:342–347.

3. Emery SE, Bohlman HH, Bolesta MJ, Jones PK. Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy. Two to seventeen-year follow-up. J Bone Joint Surg Am. 1998; 80:941–951.

4. Lied B, Sundseth J, Helseth E. Immediate (0-6 h), early (6-72 h) and late (>72 h) complications after anterior cervical discectomy with fusion for cervical disc degeneration; discharge six hours after operation is feasible. Acta Neurochir (Wien). 2008; 150:111–118.

5. Choi JW, Lee JK, Moon KS, et al. Endovascular embolization of iatrogenic vertebral artery injury during anterior cervical spine surgery: report of two cases and review of the literature. Spine (Phila Pa 1976). 2006; 31:E891–E894.

6. Yu NH, Jahng TA, Kim CH, Chung CK. Life-threatening late hemorrhage due to superior thyroid artery dissection after anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2010; 35:E739–E742.

7. Sethi R, Tandon MS, Ganjoo P. Neck hematoma causing acute airway and hemodynamic compromise after anterior cervical spine surgery. J Neurosurg Anesthesiol. 2008; 20:69–70.

8. Wong TC, Lam JJ, Ko PS. Internal jugular venous thrombosis following anterior cervical spinal surgery. Orthopedics. 2005; 28:793–794.

9. Karim A, Knapp J, Nanda A. Internal jugular venous thrombosis as a complication after an elective anterior cervical discectomy: case report. Neurosurgery. 2006; 59:E705.

10. Palumbo MA, Aidlen JP, Daniels AH, Thakur NA, Caiati J. Airway compromise due to wound hematoma following anterior cervical spine surgery. Open Orthop J. 2012; 6:108–113.