The natural course of prevertebral soft tissue swelling after anterior cervical spine surgery: how long will it last?

Kim, Seok Woo; Jang, Chul-Young; Yang, Myung Ho; Lee, Seon-Jong; Yoo, Je Hyun; Kwak, Yoon Hae; Hwang, Jong Hee

doi:10.1016/j.spinee.2017.05.003

Cited by 21 publications

(25 citation statements)

References 12 publications

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“…[14] The 95% con dence intervals (CI) between radiography and ultrasonography were calculated; the clinically acceptable limit was set at ±1.96 times the standard deviation, which is the upper limit for interscan measurement variability and the threshold for a clinically signi cant change. [8,[15][16][17][18] The Pearson correlation coe cient was used to measure the relationship between the PST values according to the method (radiography versus ultrasonography).…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique Using Ultrasonography in Upper Airway Management After Anterior Cervical Decompression and Fusion

Murata

Iwasaki

Oka

et al. 2021

Preprint

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The aim is to describe an ultrasound procedure that evaluates the prevertebral soft tissue (PST) and upper airway and investigate the compatibility between X-ray and ultrasonography in PST evaluation. We included 11 radiculopathy/myelopathy patients who underwent anterior cervical decompression and fusion involving C5/6, C6/7, or both segments. The condition of the PST and upper airway was evaluated over 14 days. The Bland–Altman method was used to evaluate the degree of agreement between the PST values obtained using radiography versus ultrasonography. The Pearson correlation coefficient was used to determine the relationship between the PST measurement methods. Single-level anterior cervical decompression and fusion (ACDF) was performed in 8 cases and double-level ACDF, in 3 cases. PST and upper airway thickness peaked on postoperative day 3, with no airway complications. The Bland–Altman bias was within the prespecified clinically nonsignificant range—0.13 ± 0.36 mm (95%CI 0.04–0.22 mm). Ultrasonography effectively captured post-ACDF changes in PST and upper airway thickness and detected airway edema. Ultrasonography can help continuously assess the PST and upper airway as it is simple and has no radiation exposure risk. Therefore, radiography alone is insufficient for post-ACDF detection of airway complications and including ultrasonography may be beneficial.

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Section: Discussionmentioning

confidence: 99%

A Novel Technique Using Ultrasonography in Upper Airway Management After Anterior Cervical Decompression and Fusion

Murata

Iwasaki

Oka

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The Bland–Altman method was used to evaluate the degree of agreement between the PST values obtained using radiography versus ultrasonography [ 14 ]. The 95% confidence intervals (CIs) between radiography and ultrasonography were calculated; the clinically acceptable limit was set at ± 1.96 times the standard deviation, which is the upper limit for interscan measurement variability and the threshold for a clinically significant change [ 8 , 15 – 17 ]. The Pearson correlation coefficient was used to measure the relationship between the PST values according to the method (radiography versus ultrasonography).…”

Section: Methodsmentioning

confidence: 99%

A novel technique using ultrasonography in upper airway management after anterior cervical decompression and fusion

et al. 2022

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Background Airway complications are the most serious complications after anterior cervical decompression and fusion (ACDF) and can have devastating consequences if their detection and intervention are delayed. Plain radiography is useful for predicting the risk of dyspnea by permitting the comparison of the prevertebral soft tissue (PST) thickness before and after surgery. However, it entails frequent radiation exposure and is inconvenient. Therefore, we aimed to overcome these problems by using ultrasonography to evaluate the PST and upper airway after ACDF and investigate the compatibility between X-ray and ultrasonography for PST evaluation. Methods We included 11 radiculopathy/myelopathy patients who underwent ACDF involving C5/6, C6/7, or both segments. The condition of the PST and upper airway was evaluated over 14 days. The Bland–Altman method was used to evaluate the degree of agreement between the PST values obtained using radiography versus ultrasonography. The Pearson correlation coefficient was used to determine the relationship between the PST measurement methods. Single-level and double-level ACDF were performed in 8 and 3 cases, respectively. Results PST and upper airway thickness peaked on postoperative day 3, with no airway complications. The Bland–Altman bias was within the prespecified clinically nonsignificant range: 0.13 ± 0.36 mm (95% confidence interval 0.04–0.22 mm). Ultrasonography effectively captured post-ACDF changes in the PST and upper airway thickness and detected airway edema. Conclusions Ultrasonography can help in the continuous assessment of the PST and the upper airway as it is simple and has no risk of radiation exposure risk. Therefore, ultrasonography is more clinically useful to evaluate the PST than radiography from the viewpoint of invasiveness and convenience.

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“…This lateral radiography obtained the anterior and posterior diameters of the anterior soft tissue for C3 (for the pharyngeal airway) and C6 (for the laryngeal airway). Picture Archiving and Communication System (PACS, Siemens Magic Software, Germany) was used to measure the distance from the anterior cortex in the mid-section of each vertebral body horizontally to the spot where the shadow of the airway can be seen [15]. Figure 3Fusion results were evaluated using exion-extension radiographs obtained at 3, 6 and 12 months after surgery.…”

Section: Radiological Analysismentioning

confidence: 99%

Comparison of Recombinant Human Bone Morphogenetic Protein-2 versus Iliac Crest Autograft in Anterior Cervical Discectomy and Fusion

Shi¹,

Huang²,

Song³

et al. 2020

Preprint

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Backgroud The use of rhBMP-2 in anterior cervical discectomy and fusion (ACDF) is still “off-label” therapy because of higher incidence of potential complications such as adverse swelling, dysphagia, and airway compromise. The purpose of this study is to investigate whether the low dose rhBMP-2 (0.5 mg/level) decreases the incidence and severity of local complications in ACDF. Methods 173 consecutively patients from June 2015 to March 2016 at seven participating centers in the China were enrolled. All the patients had primary one- or two-level ACDF with either rhBMP-2(BMP, n=110) or iliac-crest bone autograft (IGB, n=63) were analyzed. Patients in both groups had compared preoperative pain and disability. The follow up timing was postoperative third days, postoperative-1, 3, 6 and 12 months. Results Patient demographics have no significantly difference between the BMP group and IGB group pre-operation (P>0.05). No significant difference in overall dysphagia incidence between the two groups (p > 0.05). There was significant difference of PSTS at C3 level between two groups at all interval time (P<0.01). There was significant difference of PSTS at C6 level at postoperative third days (P<0.01) and 3 months (0.010.05). No pseudarthrosis in both Groups. No significant difference in VAS scores, JOA and NDI .scores between two groups (P>0.05). Conclusion The adverse events associated with low dose rhBMP-2 for one- and two-level ACDF are rare. We recommend placing the rhBMP-2 carrier in the center of cage, and bilateral coverage of the carrier with excised local osteophytes.

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The natural course of prevertebral soft tissue swelling after anterior cervical spine surgery: how long will it last?

Cited by 21 publications

References 12 publications

A Novel Technique Using Ultrasonography in Upper Airway Management After Anterior Cervical Decompression and Fusion

A Novel Technique Using Ultrasonography in Upper Airway Management After Anterior Cervical Decompression and Fusion

A novel technique using ultrasonography in upper airway management after anterior cervical decompression and fusion

Comparison of Recombinant Human Bone Morphogenetic Protein-2 versus Iliac Crest Autograft in Anterior Cervical Discectomy and Fusion

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