J Korean Orthop Assoc.  2009 Apr;44(2):249-255.

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

• Suk KS
• Kim KT
• Lee JH
• Lee SH
• Kim JS
• Choi IH

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.

Keyword

Cervical spine; Prevertebral soft tissue swelling; ACDF; Cage; Plate

MeSH Terms

Diskectomy
Humans
Spine

Figure

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  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.

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  Fig. 2 Serial measurements of prevertebral soft tissue.

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  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.

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