Shane A Andrew1, Kanwaldeep S Sidhu. 1. Mount Clemens General Hospital, Michigan State University Statewide Campus System, Mount Clemens, MI, USA. shanealexandrew@hotmail.com
Abstract
INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) is a common procedure for radicular and spondylotic disease of the cervical spine. Radiographs are routinely used to evaluate complications in the postoperative ACDF patient, especially airway compromise. Our purpose was to establish baseline data on the amount of change that can be expected in the prevertebral soft tissues after this procedure in the uncomplicated asymptomatic (no airway compromise) 1 or 2-level ACDF patient. Our hypothesis was that the upper cervical spinal levels (C2-C4) would experience greater degrees of swelling than the lower cervical spine (C5-C7). To date no published data exist in the English literature upon which to judge symptomatic patients (experiencing postoperative airway distress) radiographically. METHODS: We prospectively evaluated preoperative and postoperative x-rays of 32 patients undergoing ACDF for radicular or spondylotic cervical pathology. Measurements were taken from the anterior body of the cervical spine to the posterior aspect of the airway. The postoperative differences for each level from C2 to T1 were calculated. RESULTS: We found that the greatest level of swelling or change in the prevertebral soft tissues occurred at the mid-body of C4 in uncomplicated cases with an average change of 10.7 mm. No patients measured greater than 25 mm at C4. CONCLUSIONS: As we predicted, the greatest edema was noted in the upper cervical spine. Studies need to be performed to compare the radiographic data of symptomatic patients with the baseline data we have collected.
INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) is a common procedure for radicular and spondylotic disease of the cervical spine. Radiographs are routinely used to evaluate complications in the postoperative ACDF patient, especially airway compromise. Our purpose was to establish baseline data on the amount of change that can be expected in the prevertebral soft tissues after this procedure in the uncomplicated asymptomatic (no airway compromise) 1 or 2-level ACDF patient. Our hypothesis was that the upper cervical spinal levels (C2-C4) would experience greater degrees of swelling than the lower cervical spine (C5-C7). To date no published data exist in the English literature upon which to judge symptomatic patients (experiencing postoperative airway distress) radiographically. METHODS: We prospectively evaluated preoperative and postoperative x-rays of 32 patients undergoing ACDF for radicular or spondylotic cervical pathology. Measurements were taken from the anterior body of the cervical spine to the posterior aspect of the airway. The postoperative differences for each level from C2 to T1 were calculated. RESULTS: We found that the greatest level of swelling or change in the prevertebral soft tissues occurred at the mid-body of C4 in uncomplicated cases with an average change of 10.7 mm. No patients measured greater than 25 mm at C4. CONCLUSIONS: As we predicted, the greatest edema was noted in the upper cervical spine. Studies need to be performed to compare the radiographic data of symptomatic patients with the baseline data we have collected.