Anterior approach cervical spine dysphagia

Anterior cervical discectomy and fusion (ACDF) is indicated for the treatment of various cervical pathologies, including myelopathy, cervical disc degeneration, and radiculopathy. Esophageal perforation is a rare postsurgical complication of ACDF, although it poses serious and potentially fatal outcomes. Esophageal perforation has been described as the most fatal complication of the gastrointestinal tract as delayed diagnosis can lead to sepsis and death. Diagnosis of this complication is often difficult because it can be masked by various symptoms such as recurrent aspiration pneumonia, fever, dysphagia, and neck pain...

BACKGROUND: Hangman's fractures are bilateral fractures of the C2 pars interarticularis produced during hyperextension injuries. The Levine-Edwards classification divides these fractures into 4 categories determined by injury stability. While stable fracture patterns are typically managed conservatively, prolonged traction required in unstable fractures may be superseded by surgery in its practicality. Surgical approaches can be divided into anterior and posterior: the anterior approach allows access to the disc and is used for anterior cervical discectomy and fusion (ACDF); the posterior approach includes C2 direct pedicle screw (DPS), which preserves motion segments and may be done with a minimally invasive surgery (MIS) approach...

STUDY DESIGN: A prospective multicenter study. OBJECTIVE: To compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined...

We prospectively investigated the postoperative dysphagia in cervical posterior longitudinal ligament ossification (C-OPLL) and cervical spondylotic myelopathy (CSM) to identify the risk factors of each disease and the incidence. A series of 55 cases with C-OPLL: 13 anterior decompression with fusion (ADF), 16 posterior decompression with fusion (PDF), and 26 laminoplasty (LAMP), and a series of 123 cases with CSM: 61 ADF, 5 PDF, and 57 LAMP, were included. Vertebral level, number of segments, approach, and with or without fusion, and pre and postoperative values of Bazaz dysphagia score, C2-7 lordotic angle (∠C2-7), cervical range of motion, O-C2 lordotic angle, cervical Japanese Orthopedic Association score, and visual analog scale for neck pain were investigated...

OBJECTIVE: The optimal surgical approach for patients with multilevel degenerative cervical myelopathy (DCM) remains unknown. This systematic review and meta-analysis sought to compare anterior cervical discectomy and fusion (ACDF) versus posterior decompression (PD) in patients with DCM spanning ≥ 2 levels without ossification of the posterior longitudinal ligament. METHODS: MEDLINE and PubMed were searched from inception to February 22, 2022. The primary outcomes were Neck Disability Index (NDI), SF-36 Physical Component Summary (PCS), modified Japanese Orthopaedic Association (mJOA) scale, visual analog scale (VAS), and EQ-5D scores...

Background Though there is ongoing controversy regarding the best treatment option for cervical spine dislocation (CSD), anterior cervical surgery with direct decompression is becoming widely accepted. However, managing all cases of subaxial CSD entirely by a single anterior approach is rarely seen in the published literature. Methods The study comprised patients with subaxial CSD who underwent surgical stabilization utilizing a single anterior approach. Most of the CSD was reduced and anterior cervical discectomy and fusion (ACDF) were performed...

BACKGROUND: In the context of anterior approach to the cervical spine, dysphagia is a common complication and still without a clear distinction of risk factors. OBJECTIVE: To analyze the risk factors of dysphagia after cervical spine surgery. METHODS: Multicenter prospective study evaluated patients who underwent anterior cervical spine surgery for degenerative pathologies, studying surgical, anesthesia, base disease, and radiological variables (preoperatively, 24 hours, 1 and 3 weeks, and 6 months after surgery), with control group matched...

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BACKGROUND CONTEXT: Dysphagia is one of the postoperative complications of cervical degenerative disorders. However, few studies have evaluated the pre- and postoperative swallowing function in detail. PURPOSE: To analyze pre- and postoperative swallowing dynamics kinetically and investigate factors associated with postoperative dysphagia in patients with cervical degenerative disorders. STUDY DESIGN: Retrospective review of prospectively collected data...

The anterior cervical discectomy and fusion is a common and effective treatment for degenerative cervical myelopathy, either with or without concomitant radiculopathy. In many cases, patients with degenerative cervical spondylosis can present with disease at multiple levels. With each additional level included in the procedure, rates of complication rate can increase-both due to the nature of the anterior cervical approach (dysphagia) as well as fusion across all levels. Here, we review several technical considerations with the goal of increasing efficiency and improving outcomes with the 3-level anterior cervical discectomy and fusion...

Ossification of the anterior longitudinal ligament (OALL) in the cervical spine is a common entity but rarely causes dysphagia, dyspnea, and dysphonia. We report an OALL case which causes such symptoms. A 47-year-old female patient had a complaint of progressive difficulty swallowing for 2 months. A cervical X-ray and computerized tomography scan were taken afterward, which showed OALL at the C3-7 level. She then had esophageal endoscopy to rule out other dysphagia-related disorders. The patient underwent anterior osteotomy via anterior cervical approach with significant relief of dysphagia postoperatively...

This article deals with incidents which involved damages that could have been prevented. This includes patients who have been suffocated and have suffered irreversible damage, unfortunately, as far as we know, due to the powerlessness of the medical staff who did not act suitably. The disasters have happened as a result of upper respiratory airway obstruction by a blood clot (retropharyngeal hematoma) that developed as a complication after an anterior cervical surgery (spine/carotid artery) or after a sharp cervical injury...

Background: The anterior approach to the cervical spine is the most commonly used surgery with effective decompression and less surgical trauma. Anterior plate construct (APC) is considered a standard technique. However, it appears to cause implant failure and postoperative dysphagia. Due to these reasons, locking stand-alone cages (LSCs) without the addition of an anterior plate have been developed and gained popularity in the past decade. In theory, an LSC could provide immediate load-bearing support to the anterior column of the cervical spine and may enhance the rate of arthrodesis...

RATIONALE: Esophageal cervical spondylosis is rare in clinical practice, and the patients with cervical disc herniation are more rare. PATIENT CONCERNS: A 56 year old male patient had dysphagia for 2 years, which was more obvious in the last month, and presented with pain and numbness in the right shoulder and upper arm. DIAGNOSIS: The patient suffered from dysphagia. Gastroscope showed that the inner membrane of the esophagus was intact, chronic esophagitis, local smooth swelling, and no new organisms...

STUDY DESIGN/SETTING: A retrospective cohort study. OBJECTIVE: To evaluate the clinical efficacy of the self-locking stand-alone cage (SA) and conventional cage-plate construct (CPC) in treating degenerative cervical spondylosis with a 5-year follow-up. SUMMARY OF BACKGROUND DATA: The stand-alone approach was designed to reduce complications associated with traditional anterior cervical discectomy and fusion (ACDF). These techniques have been shown to have satisfactory short-term clinical outcomes...

OBJECTIVE: Adult cervical deformity (ACD) has high complication rates due to surgical complexity and patient frailty. Very few studies have focused on longer-term outcomes of operative ACD treatment. The objective of this study was to assess minimum 2-year outcomes and complications of ACD surgery. METHODS: A multicenter, prospective observational study was performed at 13 centers across the United States to evaluate surgical outcomes for ACD. Demographics, complications, radiographic parameters, and patient-reported outcome measures (PROMs; Neck Disability Index, modified Japanese Orthopaedic Association, EuroQol-5D [EQ-5D], and numeric rating scale [NRS] for neck and back pain) were evaluated, and analyses focused on patients with ≥ 2-year follow-up...

Diffuse idiopathic skeletal hyperostosis (DISH) is an ossifying and ankylosing skeletal condition that can be associated with DISH-related dysphagia in the case of cervical involvement. In contrast to most cases of dysphagia, which are managed conservatively, DISH-related dysphagia can be discouraging due to the progressive nature of DISH. We report two cases of DISH-related dysphagia that were treated with the surgical removal of osteophytes via an anterolateral approach. We were able to remove osteophytes using the bottleneck point as an anatomical landmark between the vertebral body and the bony excrescence...

BACKGROUND AND IMPORTANCE: Superior laryngeal nerve (SLN) injury after high cervical dissection can result in changes in vocal pitch due to cricothyroid denervation and dysphagia with aspiration risk because of decreased sensation of the supraglottic larynx. CLINICAL PRESENTATION: We describe a 69-year-old singer with cervical spondylotic myelopathy who underwent elective C3/4 and C4/5 anterior cervical diskectomy and fusion. Postoperatively, the patient reported changes in his voice, most noticeable with higher registers...

Background: Ossification of the anterior longitudinal ligament (OALL) of the cervical spine is a relatively rare disease. If patients present with dysphagia, hoarseness, and/or dyspnea, they may require surgery. Case Description: Over a 7-month period, a 55-year-old female with a history of cerebral palsy developed a progressive quadriparesis accompanied by diffuse sensory loss (i.e., clumsiness of the hand/legs and gait disturbance). The cervical spine X-rays showed atlanto-axial subluxation with instability, while the cervical MRI demonstrated "pseudotumor in the retro-odontoid" region...

BACKGROUND: Radiculopathy and myelopathy resulting from degenerative disc disease are currently treated with anterior cervical discectomy and fusion (ACDF), but there is a high incidence of adjacent segment disease after treatment. METHODS: With recent advances in cervical disc arthroplasty (CDA), we performed a review of published articles, examining the latest clinical data on the efficacy, safety, and complications of the current cervical disc devices on the market...