scholarly journals Analysis of 5 Rare Cases of Esophageal Fistula after Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation Surgeries

2020 ◽  
Author(s):  
Yu Huang ◽  
Jin Lin ◽  
Lihan Zhou ◽  
Jianhua Lin ◽  
Xuanwei Chen
Keyword(s):  
Cervical Spine ◽  
Mortality Rate ◽  
Pulmonary Infection ◽  
Internal Fixator ◽  
Esophageal Fistula ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Surgery ◽  
Treatment Measures ◽  
Anterior Cervical Surgery

Abstract Objective: To retrospectively analyze and discuss the characteristics of the pathogenesis, diagnosis and treatment of esophageal fistula after anterior cervical surgery. Methods: A retrospective analysis of the clinical data of 5 patients complicated with esophageal fistula after anterior cervical surgery in our hospital from January 2003 to December 2018 was performed. Results: Of the 5 patients, 3 died of severe pulmonary infection and sepsis after conservative treatment, and 2 patients healed after surgery performed for debridement and internal fixator removal. Conclusion: Esophageal fistula after anterior cervical spine surgery is a rare and serious complication with a high mortality rate. Surgical debridement and removal of the internal fixator accompanied by other active treatment measures can achieve good curative effects and significantly improve the outcomes of patients.

Clinical efficacy analysis of the new PRUNUS spine plate system for anterior cervical spine surgery

2020 ◽  
Author(s):  
Xiao-feng Zhao ◽  
Xiang-dong Lu ◽  
Yi-bo Zhao ◽  
De-tai Qi ◽  
Wen-xuan Wang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Blood Loss ◽  
Internal Fixation ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Surgery ◽  
Plate System

Abstract BACKGROUND To observed and evaluated the clinical efficacy of a new type cervical anterior screw plate system development for anterior cervical surgery. Methods 27 patients with cervical spine disease treated with new PRUNUS nail plate internal fixation were selected as observation group, and 29 patients treated with conventional cervical anterior screw fixation were selected as the control group. Cervical stability, internal fixation position and bone graft fusion were evaluated according to imaging data. The operative time, intraoperative blood loss, cervical Cobb angle, VAS scores, and JOA scores were compared between the two groups. Spinal function scores and neurological improvement rates were used to evaluate the clinical efficacy of the new PRUNUS spine plate. Results There were statistical differences in operation time and blood loss between the two groups (P<0.05). The difference in Cobb angle, JOA score and improvement rate, VAS score before and after surgery in two groups were statistically significant (P<0.05), but no significant differences between two groups (P>0.05). Conclusion The new PRUNUS spine plate system can be applied to the anterior cervical spine surgery, and its clinical efficacy was similar to the traditional cervical anterior plate. But PRUNUS simplified the operation process, especially for the osteoporosis patients.

scholarly journals Frequency, recognition, and management of postoperative hematomas following anterior cervical spine surgery: A review

2020 ◽  
Vol 11 ◽  
pp. 356
Author(s):  
Nancy Epstein
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Early Recognition ◽  
Case Reports ◽  
Case Series ◽  
Improvement Program ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Surgery ◽  
Anterior Corpectomy

Background: We reviewed the frequency, recognition, and management of postoperative hematomas (HT) (i.e. retropharyngeal [RFH], wound [WH], and/or spinal epidural hematomas [SEH]) following anterior cervical discectomy/fusion (ACDF), anterior corpectomy fusion (ACF), and/or anterior cervical spine surgery (ACSS). Methods: Postoperative cervical hematomas following ACDF, ACF, and ACSS ranged from 0.4% to 1.2% in a series of 11 studies involving a total of 44, 030 patients. These included; 4 single case reports, 2 small case series (6 and 30 cases), 4 larger series (758–2375 for a total of 6729 patients), an a large NSQUIP (National Surgical Quality Improvement Program ) Database involving 37,261 ACDF patients. Results: Risk factors contributing to postoperative cervical hematomas included; DISH (diffuse idiopathic skeletal hyperostosis), ossification of the posterior longitudinal ligament (OPLL), therpeutic heparin levels, longer operative times, multilevel surgery, ASA Scores of +/= 3, (American Society of Anesthesiologists), prone surgery, operative times > 4 hours, smoking, higher/lower body mass index (BMI), anemia, age >65, > medical comorbidities, and male gender. Notably, the use of drains did not prevent HT, and did not increase the infection, or reoperation rates. Conclusion: In our review of 11 studies focused on anterior cervical surgery, the incidence of postoperative hematomas ranged from 0.4 to 1.2%. Early recognition of these postoperative hemorrhages, and appropriate management (surgical/non-surgical) are critical to optimize recovery, and limit morbidity, and mortality.

The Role of the Sternocleidomastoid Muscle Flap for Esophageal Fistula Repair in Anterior Cervical Spine Surgery

Spine ◽  
2005 ◽  
Vol 30 (20) ◽  
pp. E617-E622 ◽  
Author(s):  
Ramon Navarro ◽  
Ramin Javahery ◽  
Frank Eismont ◽  
David J. Arnold ◽  
Nitin N. Bhatia ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Muscle Flap ◽  
Sternocleidomastoid Muscle ◽  
Esophageal Fistula ◽  
Fistula Repair ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Sternocleidomastoid Muscle Flap

scholarly journals Return-to-active-duty rates after anterior cervical spine surgery in military pilots

2018 ◽  
Vol 45 (6) ◽  
pp. E10
Author(s):  
Charles A. Miller ◽  
Jason H. Boulter ◽  
Daniel J. Coughlin ◽  
Michael K. Rosner ◽  
Chris J. Neal ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spondylosis ◽  
Active Duty ◽  
Disc Replacement ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Us Military ◽  
Cervical Surgery ◽  
Military Pilots

OBJECTIVESymptomatic cervical spondylosis with or without radiculopathy can ground an active-duty military pilot if left untreated. Surgically treated cervical spondylosis may be a waiverable condition and allow return to flying status, but a waiver is based on expert opinion and not on recent published data. Previous studies on rates of return to active duty status following anterior cervical spine surgery have not differentiated these rates among military specialty occupations. No studies to date have documented the successful return of US military active-duty pilots who have undergone anterior cervical spine surgery with cervical fusion, disc replacement, or a combination of the two. The aim of this study was to identify the rate of return to an active duty flight status among US military pilots who had undergone anterior cervical discectomy and fusion (ACDF) or total disc replacement (TDR) for symptomatic cervical spondylosis.METHODSThe authors performed a single-center retrospective review of all active duty pilots who had undergone either ACDF or TDR at a military hospital between January 2010 and June 2017. Descriptive statistics were calculated for both groups to evaluate demographics with specific attention to preoperative flight stats, days to recommended clearance by neurosurgery, and days to return to active duty flight status.RESULTSAuthors identified a total of 812 cases of anterior cervical surgery performed between January 1, 2010, and June 1, 2017, among active duty, reserves, dependents, and Department of Defense/Veterans Affairs patients. There were 581 ACDFs and 231 TDRs. After screening for military occupation and active duty status, there were a total of 22 active duty pilots, among whom were 4 ACDFs, 17 TDRs, and 2 hybrid constructs. One patient required a second surgery. Six (27.3%) of the 22 pilots were nearing the end of their career and electively retired within a year of surgery. Of the remaining 16 pilots, 11 (68.8%) returned to active duty flying status. The average time to be released by the neurosurgeon was 128 days, and the time to return to flying was 287 days. The average follow-up period was 12.3 months.CONCLUSIONSAdhering to military service-specific waiver guidelines, military pilots may return to active duty flight status after undergoing ACDF or TDR for symptomatic cervical spondylosis.

Delayed pharyngo-oesophageal perforation after anterior cervical spine surgery

2020 ◽  
Vol 66 (5) ◽  
pp. 414-416
Author(s):  
V. Poissonnet ◽  
V. Lubrano ◽  
A. Sadeler ◽  
E. Chabrillac
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Oesophageal Perforation ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

scholarly journals Bilateral cervical plexus block for anterior cervical spine surgery: study protocol for a randomised placebo-controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michael J. Mulcahy ◽  
Thananchayan Elalingam ◽  
Kevin Jang ◽  
Mario D’Souza ◽  
Matthew Tait
Keyword(s):  
Cervical Spine ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Cervical Plexus ◽  
Cervical Spine Surgery ◽  
Quality Of Recovery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Plexus Block ◽  
Plexus Block

Abstract Background There has been increasing focus to improve the quality of recovery following anterior cervical spine surgery (ACSS). Postoperative pain and nausea are the most common reasons for prolonged hospital stay and readmission after ACSS. Superficial cervical plexus block (SCPB) provides site-specific analgesia with minimal side effects, thereby improving the quality of recovery. The aim of our study was to investigate the effect bilateral cervical plexus block has on postoperative recovery in patients undergoing ACSS. Methods The study is a pragmatic, multi-centre, blinded, parallel-group, randomised placebo-controlled trial. 136 eligible patients (68 in each group) undergoing ACSS will be included. Patients randomised to the intervention group will have a SCPB administered under ultrasound guidance with a local anaesthetic solution (0.2% ropivacaine, 15mL); patients randomised to the placebo group will be injected in an identical manner with a saline solution. The primary outcome is the 40-item quality of recovery questionnaire score at 24 h after surgery. In addition, comparisons between groups will be made for a 24-h opioid usage and length of hospital stay. Neck pain intensity will be quantified using the numeric rating scale at 1, 3, 6 and at 24 h postoperatively. Incidence of nausea, vomiting, dysphagia or hoarseness in the first 24 h after surgery will also be measured. Discussion By conducting a blinded placebo trial, we aim to control for the bias inherently associated with a tangible medical intervention and show the true treatment effect of SCPB in ACSS. A statistically significant result will indicate an overall improved quality of recovery for patients; alternatively, if no benefit is shown, this trial will provide evidence that this intervention is unnecessary. Trial registration ClinicalTrials.gov ACTRN12619000028101. Prospectively registered on 11 January 2019 with Australia New Zealand Clinical Trials Registry

Traction Diverticulum of the Hypopharynx following Anterior Cervical Spine Surgery

1991 ◽  
Vol 100 (10) ◽  
pp. 852-855 ◽  
Author(s):  
Yves Goffart ◽  
Jacques Lenelle ◽  
Pierre Moreau ◽  
Jean Boverie
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

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.

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