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Anterior approach cervical spine dysphagia

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...
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). OBJECTIVE: 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...
July 22, 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...
July 22, 2016: 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
Nicolas H von der Hoeh, Anna Voelker, Jan S Jarvers, Jens Gulow, Christoph E Heyde
PURPOSE: The objective of this study was to investigate the outcome of a case series of patients with dysphagia resulting from diffuse idiopathic skeletal hyperostosis (DISH) of the cervical spine who were treated surgically with resection and fusion. METHODS: A retrospective study was performed on all patients who presented (2005-2013) with complaints of dysphagia or respiratory compromise and who underwent anterior cervical osteophyte resection with fusion (polyether ether ketone cage and/or plate system) using an anterior approach...
May 2015: European Spine Journal
Matthew J McGirt, Saniya S Godil, Tim E Adamson, Domagoj Coric, E Hunter Dyer, Anthony L Asher
INTRODUCTION: In the era of current healthcare reforms, all stakeholders have adopted value-based purchasing strategies to shift care toward higher benefit and lower cost treatment approaches. Degenerative spine disease is highly prevalent and its surgical intervention costly. In this study, we set out to quantify the potential cost savings and patient-centered benefits associated with performing anterior cervical diskectomy and fusion (ACDF) in an ambulatory surgery center vs inpatient hospital setting...
August 2014: Neurosurgery
Víctor Rodrigo Paradells, Juan Bosco Calatayud Pérez, Francisco Javier Díar Vicente, Luciano Bances Florez, Marta Claramonte de la Viuda, Francisco Javier Villagrasa
BACKGROUND: The number of esophageal and pharyngeal perforations occurring in anterior cervical surgeries ranges from 0.25% to 1% and 0.2% to 1.2%, respectively. Symptoms usually appear postoperatively and are attributed to: Local infection, fistula, sepsis, or mediastinitis. Acute postoperative hematoma, although very rare (<1%), is the first complication to rule out due to its life-threatening complications (e.g. acute respiratory failure). CASE DESCRIPTION: Over a 36-year period, the author(s) described three severe esophageal/pharyngeal complications attributed to anterior cervical surgery...
2014: Surgical Neurology International
F Certo, G Sciacca, R Caltabiano, G Albanese, A Borderi, V Albanese, M Migliore, G M V Barbagallo
INTRODUCTION: Osteochondromas are common benign bone tumors, rarely involving the spine. BACKGROUND: Osteochondroma account for about 35% of bone benign tumors and 9% of all bone tumors. Spinal involvement is described in 1%-4% of cases and their origin from the anterior surface of cervical vertebral bodies is exceedingly rare. AIM: We describe the rare case of an osteochondroma arising from the anterior surface of the C4 and C5 vertebral bodies, and not involving the spinal canal, in a 68-year-old male patient suffering from Diffuse Idiopathic Skeletal Hyperostosis (DISH)...
2014: European Review for Medical and Pharmacological Sciences
Jin Seop Hwang, Chung Kee Chough, Won Il Joo
Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5...
September 2013: Korean Journal of Spine
Seong Jung Kim, Chang Il Ju, Dong Min Kim, Seok Won Kim
Although anterior approaches to the cervical spine are popular and safe, they cause some of complications. Esophageal perforation after anterior spinal fusion is a rare but potentially life-threatening complication. We present a rare case of delayed esophageal perforation caused by a cervical screw placed via the anterior approach. A 43-year-old man, who had undergone surgery for complete cord injury at another orthopedic department 8 years previously, was admitted to our institute due to painful neck swelling and dysphagia...
September 2013: Korean Journal of Spine
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