scholarly journals Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal

2015 ◽  
Vol 2 (LATEST ONLINE) ◽  
Author(s):  
Johannes Borkert ◽  
Annika Hirte ◽  
Jacobus Reimers ◽  
Nicoline Jochmann ◽  
Sigrid Nikol
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Vertebral Artery ◽  
Cranial Computed Tomography ◽  
Cervical Disc ◽  
Focal Neurological Deficit ◽  
Cervical Spine Surgery ◽  
Vertebral Arteries ◽  
Endovascular Embolisation ◽  
Arterial Bleeding

Introduction: The incidence of vertebral artery (VA) injury during cervical spine surgery is rare. Even though tamponade is effective in many cases, early consultation of an endovascular team is recommended if bleeding cannot be controlled. We report a case of emergent endovascular embolisation of left VA due to iatrogenic injury during anterior cervical disc removal and fusion. Case: A 47-year-old woman was admitted to our emergency department with serious arterial bleeding from the neck only hours after undergoing anterior cervical disc removal and fusion surgery.  She was intubated and mechanically ventilated, however hemorrhage could not be successfully controlled by packing with surgical hemostatic agents. Cranial computed tomography, computed tomography of the cervical spine and CT angiography confirmed the suspected diagnosis of injury to the VA. Emergent endovascular embolisation successfully stopped the bleeding. Occlusion of the vessel was achieved by vascular plugging. The patient was discharged from our hospital 14 days after the intervention, receiving a revision surgery of the cervical spine on the day of embolisation. At the date of discharge she presented without any focal neurological deficit. Conclusion: Pre-operative radiographic imaging of the cervical spine should be used routinely to identify anatomic abnormalities of the vertebral arteries. Endovascular embolisation appears to be effective in treating acute iatrogenic dissection of the vertebral arteries.

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

A Correlation Analysis Between Postoperative Dysphagia and Change of C2-C7 Angle after Anterior Cervical Spine Surgery

2021 ◽  
Author(s):  
Jie Yu ◽  
Xiaohui Tao
Keyword(s):  
Cervical Spine ◽  
Spinal Surgery ◽  
Cervical Disc ◽  
Cervical Lordosis ◽  
Postoperative Dysphagia ◽  
Cervical Spine Surgery ◽  
Cervical Disc Replacement ◽  
Anterior Cervical Spine Surgery ◽  
Angle Change

Abstract Background. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities in clinical practice. Studies suggest that excessive O-C2 angle change at occipital-cervical fusion causes the oropharyngeal volume reduction leading to severe dysphagia and even respiratory distress after operation. However, rare study has accessed the impact of C2-C7 angle change on the occurrence of dysphagia after anterior cervical spinal surgery. Methods. From June 2007 to May 2010, A total of 198 patients was treated with anterior cervical decompression and plate fixation and 12 months follow-up was completed in 172 patients. Within the same session, a total of 154 patients underwent anterior cervical disc replacement and at least 1-year follow-up was completed in 98 patients. All 270 patients who participated in this study completed a questionnaire (Bazaz dysphagia questionnaire) after telephone follow-up including the onset and time of appearance of dysphagia, symptom relief, treatment plan and so on. To determine whether excessive cervical lordosis change (change of C2-C7 angle) and other risk factors were associated with the dysphagia symptom, all patients were divided into the dysphagia group and the control group, followed over 12 months.Results. The results showed that 12.8% presented with postoperative dysphagia in anterior cervical discectomy and fusion (ACDF) group and 5.1% in cervical disc replacement (CDR) group. According to the regression equation, the excessive change of C2-C7 angle can significantly increase the incidence rate of postoperative dysphagia. The incidence rate of postoperative dysphagia in patients whose C2-C7 angle change more than 5 degree was significantly greater than patients less than 5 degree. Sex, age, BMI, operation time, blood loss, surgery approach (anterior/posterior), revision ratio, the number of surgical segments, the highest surgical segment, and C3 segment included or not cannot affect the occurrence of dysphagia. Conclusions. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities. Cervical lordosis change is an important influencing factor on the occurrence of dysphagia after anterior cervical spine surgery.

scholarly journals Bithalamic Infarction (Artery of Percheron Occlusion) after Anterior Cervical Discectomy and Fusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Hatem B. Afana ◽  
Nidal M. M. Abuhadrous ◽  
Alaa Eldin Elsharkawy
Keyword(s):  
Vertebral Artery ◽  
Artery Occlusion ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Loss Of Consciousness ◽  
Cervical Discectomy ◽  
Sudden Loss ◽  
Cervical Spine Surgery ◽  
Artery Of Percheron ◽  
Thalamic Infarction

Bithalamic infarction resulting from occlusion of the artery of Percheron after cervical spine surgery is a rare pathological entity. Diagnosis and early detection are challenging. Prompt management may help to improve the outcome. We present a case of a 39-year-old male patient, smoker, diagnosed with multiple cervical disc herniations, who underwent Anterior Cervical Discectomy and Fusion (ACDF) for C3-C4, C4-C5, and C5-C6. During the 2-hour and 50-minute surgery, the patient was lying supine with his neck hyperextended. The intraoperative procedure was uneventful. During surgery, blood pressure ranged around 110 mmHg∖50 mmHg. At the end of surgery, the patient’s recovery from general anesthesia was normal with no delaying or complication; on next the day, patient developed a sudden loss of consciousness. Urgent brain computed tomography (CT) was normal; two days later, follow-up CT and CT Angiography (CTA) revealed bilateral thalamic infarction with right vertebral artery occlusion from its origin. Intraoperative surgical manipulation, hypotensive anesthesia, and prolonged neck hyperextension might have contributed to stroke in this patient. ACDF carries a potential risk for posterior circulation stroke. Artery of Percheron infarction should be considered in the differential diagnosis of patients developing a sudden loss of consciousness after ACDF. Vertebral artery thrombosis should be taken into account as an important possible cause of embolism.

Epidemiology of Iatrogenic Vertebral Artery Injury in Cervical Spine Surgery: 21 Multicenter Studies

2019 ◽  
Vol 126 ◽  
pp. e1050-e1054 ◽  
Author(s):  
Chang-Hyun Lee ◽  
Jae Taek Hong ◽  
Dong Ho Kang ◽  
Ki-Jeong Kim ◽  
Sang-Woo Kim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Spine Surgery ◽  
Vertebral Artery Injury ◽  
Multicenter Studies ◽  
Cervical Spine Surgery ◽  
Artery Injury

Anatomical evaluation of the vertebral artery (V2) and its influence in cervical spine surgery

2018 ◽  
Vol 174 ◽  
pp. 80-85 ◽  
Author(s):  
Ho Jin Lee ◽  
Jung Hee Kim ◽  
Il Sup Kim ◽  
Jae Taek Hong
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Spine Surgery ◽  
Cervical Spine Surgery

A Novel and Reproducible Classification of the Vertebral Artery in the Subaxial Cervical Spine

2019 ◽  
Vol 18 (6) ◽  
pp. 676-683
Author(s):  
Fabian Winter ◽  
Ichiro Okano ◽  
Stephan N Salzmann ◽  
Colleen Rentenberger ◽  
Jennifer Shue ◽  
...  
Keyword(s):  
At Risk ◽  
Cervical Spine ◽  
High Risk ◽  
Vertebral Artery ◽  
Intrarater Reliability ◽  
Cross Sectional ◽  
Cervical Spine Surgery ◽  
Subaxial Cervical Spine ◽  
Anterior Posterior

Abstract BACKGROUND An injury of the vertebral artery (VA) is one of the most catastrophic complications in the setting of cervical spine surgery. Anatomic variations of the VA can increase the risk of iatrogenic lacerations. OBJECTIVE To propose a novel and reproducible classification system that describes the position of the VA based on a 2-dimensional map on computed tomography angiographs (CTA). METHODS This cross-sectional retrospective study reviewed 248 consecutive CTAs of the cervical spine at a single academic institution between 2007 and 2018. The classification consists of a number that characterizes the location of the VA from the medio-lateral (ML) aspect of the vertebral body. In addition, a letter describes the VA location from the anterior-posterior (AP) aspect. The reliability and reproducibility were assessed by 2 independent raters on 200 VAs. RESULTS The inter- and intrarater reliability values showed the classification's reproducibility. The inter-rater reliability weighted κ-value for the ML aspect was 0.93 (95% CI: 0.93-0.93). The unweighted κ-value was 0.93 (95% CI: 0.86-1.00) for “at-risk” positions (ML grade ≥1), and 0.87 (95% CI: 0.75-1.00) for “high-risk” positions (ML grade ≥2). The weighted κ-value for the intrarater reliability was 0.94 (95% CI: 0.95-0.95). The unweighted κ-values for the intrarater reliability were 0.95 (95% CI: 0.91-0.99) for “at-risk” positions, and 0.87 (95% CI: 0.78-0.96) for “high-risk” positions. CONCLUSION The proposed classification is reliable, reproducible, and independent of individual anatomic size variations. The use of this novel grading system could improve the understanding and interdisciplinary communication about VA anomalies.

scholarly journals Postoperative Urinary Retention Following Anterior Cervical Spine Surgery for Degenerative Cervical Disc Diseases

2013 ◽  
Vol 5 (2) ◽  
pp. 134 ◽  
Author(s):  
Hyun Ju Jung ◽  
Jong-Beom Park ◽  
Chae-Gwan Kong ◽  
Young-Yul Kim ◽  
Jangsu Park ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Urinary Retention ◽  
Spine Surgery ◽  
Cervical Disc ◽  
Postoperative Urinary Retention ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery
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