Airway adverse events following posterior occipito-cervical spinal fusion

Sheshadri, Veena; Moga, Rebecca; Manninen, Pirjo; Goldstein, Christina L.; Rampersaud, Y. Raja; Massicotte, Eric M.; Fehlings, Michael G.; Venkatraghavan, Lashmi

doi:10.1016/j.jocn.2016.12.036

Cited by 18 publications

(19 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Blood and fluid-volume management can pose significant challenges during lengthy and invasive cervical spine surgeries [38]. This is particularly true in CK surgery.…”

Section: Surgical and Clinical Resultsmentioning

confidence: 99%

Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project

et al. 2018

View full text Add to dashboard Cite

Introduction and purpose Little information exists on surgical characteristics, complications and outcomes with corrective surgery for rigid cervical kyphosis (CK). To collate the experience of international experts, the CSRS-Europe initiated an international multi-centre retrospective study. Methods Included were patients at all ages with rigid CK. Surgical and patient specific characteristics, complications and outcomes were studied. Radiographic assessment included global and regional sagittal parameters. Cervical sagittal balance was stratified according to the CSRS-Europe classification of sagittal cervical balance (types AD). Results Eighty-eight patients with average age of 58 years were included. CK etiology was ankylosing spondlitis (n = 34), iatrogenic (n = 25), degenerative (n = 9), syndromatic (n = 6), neuromuscular (n = 4), traumatic (n = 5), and RA (n = 5). Blood loss averaged 957 ml and the osteotomy grade 4.CK-correction and blood loss increased with osteotomy grade (r = 0.4/0.6, p < .01). Patients with different preop sagittal balance types had different approaches, preop deformity parameters and postop alignment changes (e.g. C7-slope, C2-7 SVA, translation). Correction of the regional kyphosis angle (RKA) was average 34° (p < .01). CK-correction was increased in patients with osteoporosis and osteoporotic vertebrae (POV, p = .006). 22% of patients experienced a major long-term complication and 14% needed revision surgery. Patients with complications had larger preop RKA (p = .01), RKA-change (p = .005), and postop increase in distal junctional kyphosis angle (p = .02). The POV-Group more often experienced postop complications (p < .0001) and revision surgery (p = .02). Patients with revision surgery had a larger RKA-change (p = .003) and postop translation (p = .04). 21% of patients had a postop segmental motor deficit and the risk was elevated in the POV-Group (p = .001). Conclusions Preop patient specific, radiographic and surgical variables had a significant bearing on alignment changes, outcomes and complication occurrence in the treatment of rigid CK.

show abstract

“…Blood and fluid-volume management can pose significant challenges during lengthy and invasive cervical spine surgeries [38]. This is particularly true in CK surgery.…”

Section: Surgical and Clinical Resultsmentioning

confidence: 99%

Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project

et al. 2018

View full text Add to dashboard Cite

show abstract

“…So far, only a few articles on the OCD measurements have been reported, and both of these articles showed that the mean neutral OCD value was significantly different from those in flexion and extension positions (Fig. 3) [4,5,9].However, there was no significant difference in the OC4D measurement method among neutral, flexion, and extension positions. It has clinical significance for guiding reduction during the operation but the occiputcervical region is not in a neutral position.…”

Section: Discussionmentioning

confidence: 99%

“…Sherekar et al [6].measured the occipito-C2 angle in 518 asymptomatic volunteers (261 male and 257 female subjects), and they obtained values of 14.66 ± 9.5° in males and 15.59 ± 8.26° in females. Many researchers reported that non-normal occipitocervical angles led to poor postoperative fusion, even severe dysphagia and/or dyspnea during OCF [3,[7][8][9]. However, it is still unknown whether dysphagia and/or dyspnea mostly due to mechanical airway obstruction caused by a non-normal occipitocervical angle.…”

Section: Discussionmentioning

confidence: 99%

A novel method for measurement of occipital-cervical distance by occiput-C4 distance

Tang¹,

Yang²,

Liao³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: To describe and measure the occipital-cervical distance by a novel method utilizing the occiput-C4 distance (OC4D) in normal subjects that can be used to guide the restoration of vertical dislocation of the occipitocervical region in patients with basilar invagination and to perform standardized testing of occipitocervical constructs.Methods: Neutral, flexion, and extension lateral cervical spine radiographs of 150 asymptomatic subjects (73 males and 77 females) judged to be normal were analyzed. The mean age was 48.0±8.4 years old (range 20–69 years; 48.4±10.2 years old for males and 47.6±6.4 years old for females). Analysis consisted of measurement of the OC4D. The OC4D was defined as the shortest distance from the center of the C4 vertebral body to the McGregor’s line. Two spine surgeons measured the OC4D thrice in the normal population and obtained the average values. Height, weight, and body mass index (BMI) of each subject was recorded and analyze its correlation with OC4D.Results: The values of OC4D on neutral, flexion, and extension lateral cervical spine radiographs were 69.0±6.9 mm, 68.9±6.8 mm and 68.1±6.9 mm, respectively. There was no significantly different from the values measured in neutral、flexion and extension (P> 0.05). But the OC4D of males were higher than females in neutral, flexion, and extension (P < 0.001 for all). There was a positive correlation between OC4D and height and weight in neutral、flexion and extension (P <0.001 for all). The correlation between O-C4D and BMI was weak, and no significant in neutral, flexion, and extension (P > 0.05). The ICC values of inter- and intra-observer agreements for the radiographic parameter in all of the cervical positions were more than 0.93.Conclusions: OC4D, a new measurement method for occipital-cervical distance that is not affected by the change in neutral, flexion, and extension positions, should be a valuable parameter and intra-operative tool to guide the vertical restoration during OCF for patients with altered occiput-cervical anatomy.

show abstract

“…Conceptually, the occipitocervical neutral position is the functional and balanced position of the head atop the cervical spine. We considered that patients should [3,[8][9][10]. However, it remains unknown whether dysphagia and/or dyspnea are mostly due to mechanical airway obstruction caused by a non-normal occipitocervical angle.…”

Section: Discussionmentioning

confidence: 99%

A novel method for measurement of the occipital-cervical distance via the occiput-C4 distance

Tang

Yang

Liao

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: The aim of the present study was to describe and measure the occipital-cervical distance by a novel method utilizing the occiput-C4 distance (OC4D) in normal subjects, as a proposed tool to guide restoration of vertical dislocations of the occipitocervical region in patients with basilar invaginations and for performing standardized testing of occipitocervical constructs. Methods: We analyzed neutral, flexion, and extension lateral cervical spine radiographs of 150 asymptomatic subjects (73 males and 77 females) that were judged to be normal. The mean age of the included asymptomatic subjects was 48.0 ± 8.4 years old (range 20-69 years old; 48.4 ± 10.2 years old for males and 47.6 ± 6.4 years old for females). The OC4D was defined as the shortest distance from the center of the C4 vertebral body to the McGregor's line. Occipitocervical distances (OCDs) were measured and analyzed its correlation with OC4Ds. Two spine surgeons each performed three measurements of the OC4D and OCD from each asymptomatic subject, from which our reported average values were derived. The height, weight, and body mass index (BMI) of each subject were recorded and analyzed for their correlations with the OC4D and OCD. Results: The OC4Ds from neutral, flexion, and extension lateral cervical spine radiographs were 69.0 ± 6.9, 68.9 ± 6.8, and 68.1 ± 6.9 mm, respectively. There was no significant difference in the OC4D values among neutral, flexion, and extension lateral cervical spine radiographs (P > 0.05). The neutral, flexion, and extension OCDs were 23.0 ± 4.8, 27.6 ± 6.0, and 13.8 ± 4.7 mm, respectively. In particular, the neutral OCD was significantly different from those in flexion and extension lateral cervical spine radiographs (P < 0.001). There was no significant correlation between OC4D and OCD in neutral, flexion, and extension (P > 0.05 for all). There were positive correlations between OC4D and height, as well as OC4D and weight, in neutral, flexion, and extension lateral cervical spine radiographs (P < 0.001 for all). Furthermore, the intra-class correlation coefficients for inter-and intra-observer reliabilities of OC4Ds in neutral, flexion, and extension lateral cervical spine radiographs were significantly higher than those for OCDs (P < 0.001).

show abstract

Airway adverse events following posterior occipito-cervical spinal fusion

Cited by 18 publications

References 18 publications

Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project

Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project

A novel method for measurement of occipital-cervical distance by occiput-C4 distance

A novel method for measurement of the occipital-cervical distance via the occiput-C4 distance

Contact Info

Product

Resources

About