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Anterior approach cervical spine dysphagia

Peter G Passias, Samantha R Horn, Cyrus M Jalai, Gregory Poorman, Olivia J Bono, Subaraman Ramchandran, Justin S Smith, Justin K Scheer, Daniel M Sciubba, D Kojo Hamilton, Gregory Mundis, Cheongeun Oh, Eric O Klineberg, Virginie Lafage, Christopher I Shaffrey, Christopher P Ames
BACKGROUND CONTEXT: Complication rates for adult cervical deformity are poorly characterized given the complexity and heterogeneity of cases. PURPOSE: To compare peri-operative complication rates following adult cervical deformity corrective surgery between a prospective multi-center database for cervical deformity patients (PCD) and Nationwide Inpatient Sample (NIS). STUDY DESIGN/SETTING: Retrospective review of prospective databases. PATIENT SAMPLE: 11,501 adult cervical deformity patients (11,379 patients from NIS and 122 patients from PCD database)...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
Zhaoyu Ba, Fumin Pan, Xiaoming Liu, Jianguang Zhu, Desheng Wu
The dysphagia and recurrent laryngeal nerve (RLN) palsy are the most common complications of the patients who underwent anterior cervical surgery in the current literature. These morbidities have led to the study of the impact of sidedness in anterior cervical spine surgery. However, many reports documented the left-side was more effective and safe than right-side based on the anatomy. So the right-side approach is more challenging. We retrospectively study 503 patients with cervical degenerative diseases who underwent cervical spinal surgery using anterolateral right-side approach in our spine center from September 1999 to December 2012 and evaluate the efficient and safety of the anterolateral right-side approach to treat the cervical degenerative diseases...
March 2017: International Journal of Surgery
Ömer Erdur, Hamdi Taşli, Bahtiyar Polat, Fuad Sofiyev, Fuat Tosun, Bahar Çolpan, Hakan Birkent, Kayhan Öztürk
PURPOSE: The present study was performed to share personal experiences and to discuss the advantages and disadvantages of anterior cervical osteophytes surgical procedures. METHODS: The operative records of anterior cervical osteophytes patients who did not benefit from conventional treatments and underwent osteophytectomy were analyzed retrospectively. Transoral and transcervical anterolateral methods were applied, considering both the localization of the osteophyte and the patient's preference...
January 2017: Journal of Craniofacial Surgery
Michael A Finn, Joel D MacDonald
STUDY DESIGN: Retrospective review of patients at a university hospital. OBJECTIVE: To describe the anterior approach for cervical discectomy and fusion (ACDF) at C2-C3 level and evaluate its suitability for treatment of instability and degenerative disease in this region. SUMMARY OF BACKGROUND DATA: The anterior approach is commonly used for ACDF in the lower cervical spine but is used less often in the high cervical spine. METHODS: We retrospectively reviewed a database of consecutive cervical spine surgeries performed at our institution to identify patients who underwent ACDF at the C2-C3 level during a 10-year period...
December 2016: Clinical Spine Surgery
Branko Skovrlj, Sheeraz A Qureshi
Degenerative disorders of the cervical spine requiring surgical intervention have become increasingly more common over the past decade. Traditionally, open surgical approaches have been the mainstay of surgical treatment. More commonly, minimally invasive techniques are being developed with the intent to decrease surgical morbidity and iatrogenic spinal instability. This study will review four minimally invasive cervical techniques that have been increasingly utilized in the treatment of degenerative cervical spine disease...
June 2017: Journal of Neurosurgical Sciences
Steven Leckie, S Tim Yoon, Robert Isaacs, Kris Radcliff, Richard Fessler, Regis Haid, Vincent Traynelis
Study Design Retrospective review of prospectively gathered data. Objective To report the rate and impact of perioperative complications in cervical spine surgery. To our knowledge, no prior study of the cervical spine has analyzed a large prospectively gathered data set for adverse events, based on surgical subgroup. Methods The ProSTOS database features prospectively documented perioperative adverse events for 1,269 patients who had cervical spine surgery at multiple centers in North America between 2008 and 2011...
November 2016: Global Spine Journal
Dexiang Ban, Yang Liu, Taiwei Cao, Shiqing Feng
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries and neurosurgical procedures performed to treat a variety of disorders in the cervical spine. Over the last several years, ACDF has been done in the outpatient setting for less invasive approaches and exposures, as well as modified anesthetic and pain management techniques. Despite the fact that it may be innocuous in other parts of the body, complications in the spine can literally be fatal...
August 31, 2016: European Journal of Medical Research
Shuichi Kaneyama, Masatoshi Sumi, Masato Takabatake, Koichi Kasahara, Aritetsu Kanemura, Akihiro Koh, Hiroaki Hirata
STUDY DESIGN: Kinematic analysis of swallowing function using videofluoroscopic swallowing study (VFSS). OBJECTIVES: The aims of this study were to analyze swallowing process in the patients who underwent occipitospinal fusion (OSF) and elucidate the pathomechanism of dysphagia after OSF. SUMMARY OF BACKGROUND DATA: Although several hypotheses about the pathomechanisms of dysphagia after OSF were suggested, there has been little tangible evidence to support these hypotheses since these hypotheses were based on the analysis of static radiogram or CT...
December 1, 2016: Spine
Kris Siemionow, Mark Hansdorfer, Piotr Janusz, Steven Mardjetko
Introduction Cervical spine pathologies are common in Down syndrome (DS) patients. Cervical pathologies may cause cord compression and neurologic deterioration if left untreated. Complication rates of 73-100% have been reported in DS patients after cervical spine surgery in historical studies. This study reports updated perioperative complications rates and long-term outcome in patients with DS undergoing cervical spine surgery. Methods Retrospective review of patients with DS who have undergone cervical spine surgery from 1998 to 2011 (≥ 24 months of follow-up) was undertaken...
March 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Michael A Finn, Joel D MacDonald
STUDY DESIGN: Retrospective review of patients at a university hospital OBJECTIVE:: To describe the anterior approach for cervical discectomy and fusion (ACDF) at C2-3 level and evaluate its suitability for treatment of instability and degenerative disease in this region. SUMMARY OF BACKGROUND DATA: The anterior approach is commonly used for ACDF in the lower cervical spine but is used less often in the high cervical spine. METHODS: We retrospectively reviewed a database of consecutive cervical spine surgeries performed at our institution to identify patients who underwent ACDF at the C2-3 level during a 10-year period...
May 11, 2016: Clinical Spine Surgery
Brett D Rosenthal, Rueben Nair, Wellington K Hsu, Alpesh A Patel, Jason W Savage
The Smith-Robinson approach to the anterior cervical spine is being increasingly used, but it is not without complication. Dysphagia and dysphonia are the most common complications of the procedure. Many classification systems have been developed to stage and grade postoperative dysphagia and dysphonia, but inconsistent usage and lack of consensus adoption has limited research progress. A discussion of the merits and limitations of the most common classification systems is outlined within this review. Broad adoption of comprehensive and simple classification metrics is needed, but, first, prospective reliability and validity must be established in the anterior cervical fusion population...
March 11, 2016: Clinical Spine Surgery
Rafael De la Garza-Ramos, Risheng Xu, Seba Ramhmdani, Thomas Kosztowski, Mohamad Bydon, Daniel M Sciubba, Jean-Paul Wolinsky, Timothy F Witham, Ziya L Gokaslan, Ali Bydon
OBJECTIVE The purpose of this study was to report the long-term clinical outcomes following 3- and 4-level anterior cervical discectomy and fusion (ACDF). METHODS A retrospective review of all adult neurosurgical patients undergoing elective ACDF for degenerative disease at a single institution between 1996 and 2013 was performed. Patients who underwent first-time 3- or 4-level ACDF were included; patients with previous cervical spine surgery, those undergoing anterior/posterior approaches, and those with corpectomy were excluded...
June 2016: Journal of Neurosurgery. Spine
Justin S Smith, Subaraman Ramchandran, Virginie Lafage, Christopher I Shaffrey, Tamir Ailon, Eric Klineberg, Themistocles Protopsaltis, Frank J Schwab, Michael OʼBrien, Richard Hostin, Munish Gupta, Gregory Mundis, Robert Hart, Han Jo Kim, Peter G Passias, Justin K Scheer, Vedat Deviren, Douglas C Burton, Robert Eastlack, Shay Bess, Todd J Albert, K Daniel Riew, Christopher P Ames
BACKGROUND: Few reports have focused on treatment of adult cervical deformity (ACD). OBJECTIVE: To present early complication rates associated with ACD surgery. METHODS: A prospective multicenter database of consecutive operative ACD patients was reviewed for early (≤30 days from surgery) complications. Enrollment required at least 1 of the following: cervical kyphosis >10 degrees, cervical scoliosis >10 degrees, C2-7 sagittal vertical axis >4 cm, or chin-brow vertical angle >25 degrees...
September 2016: Neurosurgery
Ethan A Winkler, Nathan C Rowland, John K Yue, Harjus Birk, Alp Ozpinar, Bobby Tay, Christopher P Ames, Praveen V Mummaneni, Ivan H El-Sayed
OBJECTIVE: Anterior cervical spine decompression and fusion are common neurosurgical operations. Reoperation of the anterior cervical spine is associated with increased morbidity. The authors describe a novel subcricoid approach to protect the recurrent laryngeal nerve in a cuff of tissue while facilitating surgical access to the anterior cervical spine. METHODS: Single institution, consecutive case review of 48 patients undergoing reoperation in the anterior cervical region including the level of C5 and below...
February 2016: World Neurosurgery
Kazuhiro Murayama, Shinichi Inoue, Toshiya Tachibana, Keishi Maruo, Fumihiro Arizumi, Shotaro Tsuji, Shinichi Yoshiya
Descriptive case report.To report a case of a diffuse idiopathic skeletal hyperostosis (DISH) patient with both massive ossification of the anterior longitudinal ligament (OALL) leading to severe dysphagia as well as ossification of the posterior longitudinal ligament (OPLL) causing mild cervical myelopathy, warranting not only an anterior approach but also a posterior one.Although DISH can cause massive OALL in the cervical spine, severe dysphagia resulting from DISH is a rare occurrence. OALLs are frequently associated with OPLL...
August 2015: Medicine (Baltimore)
C Herren, M Pishnamaz, P Lichte, F Hildebrand, R M Sellei, H-C Pape, P Kobbe
INTRODUCTION: In geriatric patients the management of odontoid type II fractures is complicated by osteoporosis and atlantoaxial arthritis (spondylarthritis C1/C2) with an increased lever arm. Furthermore, a few of the odontoid fractures are accompanied by an atlas fracture resulting in the "atlantoaxial unhappy triad". Posterior C1/C2 spondylodesis with bilateral Magerl screws and C1 hooks is a strong biomechanical construct, however, the posterior approach is associated with several drawbacks such as increased risk of infection and increased blood loss...
October 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
Abdul Satar, Zahid Wazir, Muhammad Saeed, Mohammad Arif, Mohammad Inam
OBJECTIVE: To determine the surgical outcome of patients with axial cervical spine fractures. METHODS: The study was conducted at the Spine Unit of Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to March 2013. Patients with sub-axial cervical spine fractures were treated surgically. The outcome was measured using Visual Analogue Score, Neck Disability Index, by neurology and on the basis of complications. SPSS 16 was used for statistical analysis...
December 2014: JPMA. the Journal of the Pakistan Medical Association
Andrei F Joaquim, Alpesh A Patel
Odontoid fractures comprise as many as 20% of all cervical spine fractures. Fractures at the dens base, classified by the Anderson and D'Alonzo system as Type II injuries, are the most common pattern of all odontoid fractures and are also the most common cervical injuries in patients older than 70 years of age. Surgical treatment is recommended for patients older than 50 years with Type II odontoid fractures, as well as in patients at a high risk for nonunion. Anterior odontoid screw fixation (AOSF) and posterior cervical instrumented fusion (PCIF) are both well-accepted techniques for surgical treatment but with unique indications and contraindications as well as varied reported outcomes...
April 2015: Neurosurgical Focus
Ming-sheng Tan, Hao-ning Ma, Ping Yi, Feng Yang, Xiang-sheng Tang
OBJECTIVE: To investigate the clinical effects and operative options for the treatment of Forestier disease. METHODS: From June 2005 to May 2012, 8 patients with progressive dysphagia due to Forestier disease were treated through anterior approach, their clinical data were retrospective analyzed. There were 6 males and 2 females, aged from 65 to 83 years old with an average of 73 years. Among the patients, osteophytes removal was performed in 3 cases, osteophytes removal with discectomy and fusion was performed in 2 cases, osteophytes removal with corpectomy and fusion was performed in 3 cases...
January 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yohan Song, Suzanne Tharin, Vasu Divi, Laura M Prolo, Davud B Sirjani
BACKGROUND: Transcervical approaches to the upper cervical spine are challenging because several upper anterior neurovascular structures need to be displaced to provide access. Although various techniques have been described, the anterolateral approach is one of the safest and most effective methods available to access the anterior C2-C3 disc space. Despite the approach's efficacy, however, it can cause postoperative complications because of, at least partly, the inter-surgeon differences in the methods by which the larynx and hypopharynx are displaced medially...
September 2015: Head & Neck
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