-
Tytuł:
-
Assessing the Intraoperative Risk of Esophageal Perforation during Anterior Cervical Spine Surgery: A Study Using Intraoperative Computed Tomography.
-
Autorzy:
-
Nakano A; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Nakaya Y; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Fujishiro T; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Hayama S; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Obo T; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Baba I; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Neo M; Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
-
Źródło:
-
Spine surgery and related research [Spine Surg Relat Res] 2019 Sep 04; Vol. 4 (2), pp. 124-129. Date of Electronic Publication: 2019 Sep 04 (Print Publication: 2020).
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: Tokyo, Japan : Japanese Society for Spine Surgery and Related Research, [2017]-
-
References:
-
Laryngoscope. 2010 May;120(5):930-6. (PMID: 20422686)
Spine (Phila Pa 1976). 1989 Oct;14(10):1051-3. (PMID: 2588052)
J Am Acad Orthop Surg. 2008 Dec;16(12):729-38. (PMID: 19056921)
J Neurosurg Spine. 2016 Sep;25(3):285-91. (PMID: 27081708)
J Spinal Disord Tech. 2006 May;19(3):191-3. (PMID: 16770217)
Spine (Phila Pa 1976). 2005 Oct 15;30(20):E617-22. (PMID: 16227880)
Eur Spine J. 2012 Jan;21(1):172-7. (PMID: 21874293)
J Clin Neurosci. 2013 Oct;20(10):1402-5. (PMID: 23891121)
Spine J. 2008 Sep-Oct;8(5):831-5. (PMID: 18082458)
Eur Spine J. 2005 Nov;14(9):880-6. (PMID: 16151718)
Surg Neurol. 2008 Jan;69(1):20-4; discission 24. (PMID: 17976697)
J Neurosurg Spine. 2009 Sep;11(3):320-5. (PMID: 19769513)
Int J Crit Illn Inj Sci. 2013 Oct;3(4):276-8. (PMID: 24459627)
Surgery. 1971 Feb;69(2):175-82. (PMID: 4923689)
J Neurosurg. 1999 Jan;90(1 Suppl):35-41. (PMID: 10413123)
J Clin Neurosci. 2011 Oct;18(10):1374-80. (PMID: 21775144)
Global Spine J. 2017 Apr;7(1 Suppl):28S-36S. (PMID: 28451488)
-
Contributed Indexing:
-
Keywords: anterior cervical spine surgery; complication; esophageal perforation; hybrid operation room; intraoperative CT; navigation surgery
-
Entry Date(s):
-
Date Created: 20200515 Latest Revision: 20220414
-
Update Code:
-
20240105
-
PubMed Central ID:
-
PMC7217672
-
DOI:
-
10.22603/ssrr.2019-0026
-
PMID:
-
32405557
-
Introduction: Using intraoperative computed tomography (iCT), we aimed to clarify the course of the esophagus and pharynx during anterior cervical spine surgery to estimate the risk of intraoperative injury.
Methods: Sixteen patients who underwent anterior cervical spine surgery with intraoperative CT for registration of a navigation system without release of blade retraction were included. To investigate the status of the retracted esophagus and pharynx, the distance between the nasogastric tube and center of the vertebra (NVD) was measured at each disc and vertebral level (C4-7) using axial CT. The location of the cricoid cartilage, which may affect the shift of the esophagus and pharynx, was noted. Presence or absence of contact between the esophagus and the edge of the surgical blade was investigated.
Results: The NVDs were 28.0, 28.3, 28.9, 27.2, 24.7, 19.9, and 13.8 mm at C4, C4/5, C5, C5/6, C6, C6/7, and C7, respectively; NVDs at C6/7 or more caudal levels were significantly shorter than those at C6 or more cranial levels (P < 0.001). The cricoid cartilage was observed at the C4-C5/6 level. Esophageal contact with the edge of the blade was observed in nine cases at C6 or more caudal levels.
Conclusions: The esophagus, which was placed at C6 or more caudal levels, was directly retracted by the blade. Nevertheless, the pharynx, which was placed at C6 or more cranial levels, was mostly retracted with the cricoid cartilage. Thus, the risk of direct esophageal injury was higher at C6 or more caudal levels than at cranial levels.
Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.
(Copyright © 2020 by The Japanese Society for Spine Surgery and Related Research.)
