Journal of Korean Neurosurgical Society

  • 제66권6호
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  • Pages.716-725
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  • 2023
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Sang Mook Kang (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Yu Deok Won (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Myung-Hoon Han (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Jin Hwan Cheong (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Byeong-Jin Ha (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Je Il Ryu (Department of Neurosurgery, Hanyang University Guri Hospital)
  • 투고 : 2023.06.16
  • 심사 : 2023.08.31
  • 발행 : 2023.11.01
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초록

Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

키워드

과제정보

This work was supported by the National Research Foundation of Korea Grant funded by the Korea Government (NRF-2021R1G1A1011491). The sponsor played no role in the study design, data collection, or analysis, or decision to submit the article for publication.

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