• Title/Summary/Keyword: Anterior cervical surgery

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Clinical Analysis of Postoperative Prognostic Factors of Cervical Anterior Decompression and Interbody Fusion for Ossification of Posterior Longitudinal Ligament (경추 후종인대 골화증의 전방경유 감압술 및 골 융합술후 예후인자에 대한 임상분석)

  • Sim, Sang Joon;Cho, Jun Ho;Yoo, Soo Il;Kwon, Young Dae;Lee, Yong Sung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.360-364
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    • 2000
  • Objective : To investigate the prognostic factors associated with outcome in patients with ossification of posterior longitudinal ligament. Method : During the past 4 years, we have operated on 35 patients with cervical OPLL. Anterior cervical decompression(total or subtotal corpectomy, discectomy, and removal of the OPLL) and interbody fusion with iliac bone were performed in all patients. Results : Eight cases(22.9%) were continuous type, 11(31.4%) segmental, 13(37.1%) Mixed, and 3(8.6%) localized type. Thirty-two patients(91.4%) showed an excellent or good results. Conclusion : These results indicate that surgical treatment should be considerated in case of clinical grading higher than II and the surgical outcome is worse when duration of preoperative symptom is longer and when percentage of spinal narrowing is higher. Anterior cervical decompression and interbody fusion seems to be a better method in patients with lesions limited to one or two level. Age at surgery did not significantly affect the outcom.

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A Case of Posterior Mediastinal Goiter (후종격동에 발생한 갑상선종 1예)

  • Lee, Sang-Joon;Chung, Phil-Sang;Moon, Jeong-Hwan;Lee, Ki-Il
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.155-158
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    • 2006
  • Intrathoracic goiters can be classified anterior and posterior mediastinal goiter with its locations. Most intrathoracic goiters are retrosternally situated in the anterior mediastinal compartment. Posterior mediastinal goiters are rare, but might present a difficult diagnostic and surgical problem. Although thyroid goiters are nearly always amenable to a cervical approach, posterior mediastinal goiters may require a combined cervicothoracic approach with sternotomy or thoracothomy. We herein describe a case of posterior mediastinal goiter which was excised only by cervical approach. The relevant literature is briefly reviewed.

Dysphagia Caused by Osteochondroma of the Cervical Vertebral Body: A Case Report (경추체 전방에 발생한 골연골종으로 인한 연하곤란: 증례 보고)

  • Min, Hak-Jin;Kim, Jin-Soo;Kim, Jong-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.32-36
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    • 2012
  • A 56 year-old female presented with dysphagia 8 weeks ago and newly developed dysphonia 2 weeks ago. The radiology study and swallowing difficulty evaluation study revealed the esophagus and the posterior wall of the laryngopharynx to be severely compressed by the mass of the anterior $4^{th}$ and $5^{th}$ vertebral body of cervical spine. En bloc excisional biopsy of the bony mass was performed, which completely resolved the clinical symptoms. We report a rare case of osteochondroma occurring at the anterior portion of cervical spine leading to dysphasia and dysphonia with a review of relevant literature.

Gunshot Injury to the Anterior Arch of Atlas

  • Park, Jun-Hee;Kim, Hyeung-Sun;Kim, Seok-Won;Do, Nam-Yong
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.164-166
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    • 2012
  • Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

Large Perforation of Hypopharynx Secondary to Anterior Cervical Approach : A Complicated Case

  • Park, Jun Hee;Do, Nam Yong;Kim, Seok Won;Kim, Hyeun Sung
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.377-379
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    • 2013
  • Perforation of the hypopharynx, which can occur after anterior cervical approach, is a very rare type of complication. If diagnosed late, it can lead to very fatal course, such as mediastinitis and hematosepsis. Therefore, a precise and prompt diagnosis is crucial. When conservative treatment alone is not expected to heal the perforated site or is likely to lead to serious complications, surgical treatment becomes necessary. This report demonstrates that surgical intervention performed immediately after an early diagnosis can lead to the successful treatment of a large perforation in the hypopharynx on a 58-year-old male patient.

Hypopharyngeal Wall Exposure within the Surgical Field : The Role of Axial Rotation of the Thyroid Cartilage during Anterior Cervical Surgery

  • Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa;Song, Geun-Sung;Kim, Choon-Grak;Kim, Hak-Jin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.406-411
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    • 2010
  • Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

Esophageal Injury Following Anterior Cervical Plate Fixation

  • Park, Jae-Sung;Kim, Young-Baeg;Hong, Hyun-Jong;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.141-145
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    • 2005
  • We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

Anterior Cervical Discectomy and Fusion YouTube Videos as a Source of Patient Education

  • Ovenden, Christopher Dillon;Brooks, Francis Michael
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.987-991
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    • 2018
  • Study Design: Cross sectional study. Purpose: To assess the quality of anterior cervical discectomy and fusion (ACDF) videos available on YouTube and identify factors associated with video quality. Overview of Literature: Patients commonly use the internet as a source of information regarding their surgeries. However, there is currently limited information regarding the quality of online videos about ACDF. Methods: A search was performed on YouTube using the phrase 'anterior cervical discectomy and fusion.' The Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems were used to rate the first 50 videos obtained. Information about each video was collected, including number of views, duration since the video was posted, percentage positivity (defined as number of likes the video received, divided by the total number of likes or dislikes of that video), number of comments, and the author of the video. Relationships between video quality and these factors were investigated. Results: The average number of views for each video was 96,239. The most common videos were those published by surgeons and those containing patient testimonies. Overall, the video quality was poor, with mean scores of 1.78/5 using the DISCERN criteria, 1.63/4 using the JAMA criteria, and 1.96/8 using the HON criteria. Surgeon authors' videos scored higher than patient testimony videos when reviewed using the HON or JAMA systems. However, no other factors were found to be associated with video quality. Conclusions: The quality of ACDF videos on YouTube is low, with the majority of videos produced by unreliable sources. Therefore, these YouTube videos should not be recommended as patient education tools for ACDF.

Hybrid Surgery of Multilevel Cervical Degenerative Disc Disease : Review of Literature and Clinical Results

  • Lee, Sang-Bok;Cho, Kyoung-Suok;Kim, Jong-Youn;Yoo, Do-Sung;Lee, Tae-Gyu;Huh, Pil-Woo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.452-458
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    • 2012
  • Objective : In the present study, we evaluated the effect, safety and radiological outcomes of cervical hybrid surgery (cervical disc prosthesis replacement at one level, and interbody fusion at the other level) on the multilevel cervical degenerative disc disease (DDD). Methods : Fifty-one patients (mean age 46.7 years) with symptomatic multilevel cervical spondylosis were treated using hybrid surgery (HS). Clinical [neck disability index (NDI) and Visual Analogue Scale (VAS) score] and radiologic outcomes [range of motion (ROM) for cervical spine, adjacent segment and arthroplasty level] were evaluated at routine postoperative intervals of 1, 6, 12, 24 months. Review of other similar studies that examined the HS in multilevel cervical DDD was performed. Results : Out of 51 patients, 41 patients received 2 level hybrid surgery and 10 patients received 3 level hybrid surgery. The NDI and VAS score were significantly decreased during the follow up periods (p<0.05). The cervical ROM was recovered at 6 and 12 month postoperatively and the mean ROM of inferior adjacent segment was significantly larger than that of superior adjacent segments after surgery. The ROM of the arthoplasty level was preserved well during the follow up periods. No surgical and device related complications were observed. Conclusion : Hybrid surgery is a safe and effective alternative to fusion for the management of multilevel cervical spondylosis.

Dermoid Cyst Anterior to the Cervical Trachea (경부 기도 전방에 발생한 유피낭종 1예)

  • Kim, Yoon-Hwan;Oh, Jang-Gun;Shin, Hyang-Mi;Kim, Young-Saeng
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.160-162
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    • 2009
  • Dermoid cysts are benign neoplasm that is derived from both ectoderm and mesoderm. They may be found at various sites of the body, but are extremely rare to occur in the lower neck. We present the case of a 22-year old woman with a midline cystic mass anterior to the cervical trachea. The mass was excised under local anesthesia. Histopathologically the diagnosis was confirmed as a dermoid cyst.