Prevertebral Soft Tissue Swelling after Anterior Cervical Discectomy and Fusion - Comparison between Plate Fixation and Cage Insertion -

Kyung-Soo Suk; Ki-Tack Kim; Jung-Hee Lee; Sang-Hoon Lee; Jin-Soo Kim; Il-Hun Choi

doi:10.4055/jkoa.2009.44.2.249

Journal List > J Korean Orthop Assoc > v.44(2) > 1012896

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Suk, Kim, Lee, Lee, Kim, and Choi: Prevertebral Soft Tissue Swelling after Anterior Cervical Discectomy and Fusion - Comparison between Plate Fixation and Cage Insertion -

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(2): 249-255.

Published online: 30 April 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.2.249

Prevertebral Soft Tissue Swelling after Anterior Cervical Discectomy and Fusion - Comparison between Plate Fixation and Cage Insertion -

Kyung-Soo Suk, M.D., Ki-Tack Kim, M.D., Jung-Hee Lee, M.D., Sang-Hoon Lee, M.D., Jin-Soo Kim, M.D.^*, Il-Hun Choi, M.D.

Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.

^*Department of Orthopaedic Surgery, College of Medicine, Seoul Medical Center, Seoul, Korea.

Address reprint requests to Jung-Hee Lee, M.D. Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, 1 Hoeki-dong, Dondamun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8346, Fax: +82.2-964-3865, sks111@khmc.or.kr

Abstract

Purpose

We wanted to identify the natural course of prevertebral soft tissue swelling after performing one-level or two-level anterior cervical discectomy and fusion (ACDF), and we compared the prevertebral soft tissue swelling between the plate and cage groups, and we wanted to help preventing potentially lethal airway complications after ACDF.

Materials and Methods

One hundred thirteen patients who underwent one-level or two-level ACDF with plate and screws or cages were studied. Eighty-seven patients underwent ACDF using plates and twenty-six underwent ACDF using cages. Cervical spine lateral radiography was taken preoperatively, on the immediate postoperative day and on the 1st, 2nd, 3rd, 4th and 5th days after surgery. The prevertebral soft tissue was measured from C2 to C6 on the cervical spine lateral radiography.

Results

Prevertebral soft tissue swelling occurred postoperatively and the peak level was found on the second and third days after surgery. The prevertebral soft tissue swelling was gradually decreased from the fourth day after surgery. Prominent swelling of the prevertebral soft tissue was found at the 2nd, 3rd and 4th cervical spines. There were no significant differences of the prevertebral soft tissue swelling between the one-level and two-level ACDF groups. The cage insertion group showed less swelling than did the plate fixation group.

Conclusion

The peak prevertebral soft tissue swelling was found on the second and third days after surgery. The cage insertion group showed less swelling than did the plate fixation group.

Keywords: Cervical spine, Prevertebral soft tissue swelling, ACDF, Cage, Plate

Figures and Tables

Fig. 1

The prevertebral soft tissue was measured the distance between the anterior surface of each vertebral body and the air shadow of the airway.

Fig. 2

Serial measurements of prevertebral soft tissue.

Fig. 3

ACDF C4-5 was performed due to disc herniation at C4-5 in a 42-year-old male patient who had performed open-door laminoplasty 2 weeks ago. The 2nd day after the surgery, he complained severe dyspnea. Cervical spine lateral radiography showed severe prevertebral soft tissue swelling.

Table 1

Comparison of Prevertebral Soft Tissue between Proximal to C5 Surgery Group and Distal to C5 Surgery Group

^*Prox, proximal to C5 surgery group; ^†Dist, distal to C5 surgery group.

Table 2

Comparison of Prevertebral Soft Tissue between Plate and Cage Group

References

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