J Korean Neurosurg Soc.  2007 Aug;42(2):97-102.

Relations between Airway Narrowing and Prevertebral Soft Tissue Swelling after Anterior Cervical Spine Surgery: The Value of Lateral Neck Radiographs

• Kim HS
• Youm JY
• Kwon HJ
• Choi SW
• Kim SH
• Koh HS

Abstract

OBJECTIVE
The authors attempted to evaluate the pattern of the airway narrowing due to prevertebral soft tissue swelling after surgery of the anterior cervical spine and their clinical significances using plain cervical X-ray images.
METHODS
Twenty-four patients undergoing anterior cervical spine surgery were reviewed from January 2004 to December 2005. Postoperatively, in daily basis, lateral radiograph of the neck was obtained in neutral position. We measured the upper airway diameter above and below the epiglottis level and prevertebral soft tissue diameter everyday for a week and finally 2 weeks after surgery using their simple lateral cervical X-ray films.
RESULTS
Both airway narrowing and prevertebral soft tissue swelling were maximum in postoperative 2 days, and decreased rapidly in postoperative 7 days. Airway narrowing was aggravated postoperatively but slowly decreased as prevertebral soft tissue swelling diminished. But, the severity of airway narrowing showed no clinical correlations with clinical symptom and radiologic severity.
CONCLUSION
Not all patients who show severe airway narrowing and prevertebral soft tissue swelling on their plain cervical X-ray film complain respiratory insufficiency. But, the patients with undergoing anterior cervical spine surgery should be monitored carefully for respiratory insufficiency, especially during several days following operation because both airway narrowing and prevertebral soft tissue swelling become peak at postoperative 2-3 days.

Keyword

Soft tissue; Airway obstruction; Respiratory insufficiency

MeSH Terms

Airway Obstruction
Epiglottis
Humans
Neck*
Respiratory Insufficiency
Spine*
X-Ray Film