J Korean Soc Spine Surg.  2004 Sep;11(3):168-173. 10.4184/jkss.2004.11.3.168.

Prevertebral Soft Tissue Swelling After Anterior Cervical Discectomy and Fusion

• Suk KS
• Kim KT
• Bae SC
• Chung BO

• KMID: 1839988
• DOI: http://doi.org/10.4184/jkss.2004.11.3.168

Abstract

STUDY DESIGN: Prospective study of 87 patients
OBJECTIVES
To identify the natural course of the prevertebral soft tissue swelling after a one- or two-level anterior cervical discectomy and fusion (ACDF) and to help prevent potentially lethal airway complications after an ACDF. SUMMARY OF LITERATURE REVIEW: Airway complication after anterior cervical surgery is rare but potentially lethal.
MATERIALS AND METHODS
Eighty-seven patients who underwent a one- or two-level ACDF with a plate and screws were examined. Cervical spine lateral radiography was taken preoperatively, on the immediate postoperative day, 1st, 2nd, 3rd, 4th and 5th day after surgery. Prevertebral soft tissue was measured from C2 to C6 on the cervical spine lateral radiography.
RESULTS
Prevertebral soft tissue swelling occurred postoperatively and increased markedly on the second day after surgery. The peak prevertebral soft tissue swelling was observed on the second and third day after surgery. The prevertebral soft tissue swelling was decreased gradually from the 4th day after surgery. Prominent swelling of the prevertebral soft tissue was found at the 2nd, 3rd and 4th cervical spine. There were no significant differences in the prevertebral soft tissue swelling between the one-level and two-level ACDF group. Only one patient required reintubation (1.1%)
CONCLUSIONS
The peak prevertebral soft tissue swelling was observed on the second and third day after surgery. Therefore, maintaining intubation for 3 or 4 days after surgery would be helpful in high-risk patients.

Keyword

ACDF; Cervical spine; Prevertebral soft tissue swelling

MeSH Terms

Diskectomy*
Humans
Intubation
Prospective Studies
Radiography
Spine

Figure

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

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  Fig. 2. ACDF C4-5 was performed due to disc herniation at C4-5 in a 42-year-old male patient. The 2nd day after the surgery, he complained severe dyspnea. Cervical spine lateral radiography showed severe prevertebral soft tissue swelling.

Reference

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