Airway Obstruction Caused by Soft Tissue Edema during an Anterior Cervical Approach - A Case Report -

Bong-Ju Park; Byung-Wan Choi; Ji-Hoon Chang

doi:10.4055/jkoa.2009.44.1.136

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Park, Choi, and Chang: Airway Obstruction Caused by Soft Tissue Edema during an Anterior Cervical Approach - A Case Report -

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(1): 136-140.

Published online: 23 February 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.1.136

Airway Obstruction Caused by Soft Tissue Edema during an Anterior Cervical Approach - A Case Report -

Bong-Ju Park, M.D., Byung-Wan Choi, M.D., Ji-Hoon Chang, M.D.

Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.

Address reprint requests to Byung-Wan Choi, M.D. Department of Orthopaedic Surgery, Gwang-Ju Veterans Hospital, 887-1, Sanwol-dong, Gwangju 506-705, Korea. Tel: +82.62-602-6162, Fax: +82.62-602-6989, alla1013@naver.com

Abstract

Anterior approaches to the cervical spine for performing decompression, fusion and/or instrumentation are common and useful methods for treating many conditions, including degenerative diseases. One of the rare, but serious complications of an anterior cervical approach is respiratory insufficiency as a result of upper airway obstruction, which is due to airway narrowing and prevertebral soft tissue swelling. We experienced a case of serious airway obstruction that was caused by soft tissue edema combined with postoperative hematoma after an anterior cervical spine approach. We report here on this case and include a review of the relevant literature.

Keywords: Airway obstruction, Soft tissue edema, Anterior cervical spine approach

Figures and Tables

Fig. 1

C-spine lateral X-ray film. (A) Postop. D-day, anterior cervical discectomy and fusion of C5-7 was performed. (B) Postop. 3rd day, severe prevertebral soft-tissue swelling and airway narrowing was visible. (C) Postop. 6th day, prevertebral soft-tissue swelling was resolved. But tracheal tube was reinserted due to difficulty of respiration. (D) Postop. 15th day, tracheal tube was removed. (E) Postop 6 months. there showed mild collapse of implanted cage with complete union of grafted bone.

Fig. 2

(A) Neck CT shows that spindle shaped prevertebral (Lt) and parapharyngeal (Rt) low density, 15×7 mm & 19×5 mm sized, iso-dense abscess like mass with rim enhanced. There was diffuse swelling of retro- and para-pharyngeal area. (B) Extracted soft tissue debridement was dark reddish brown colored, foul odoured and pus-like fluid mixed.

References

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