• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.97-102
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• 2007

Objective : The authors attempted to evaluate the pattern of the airway narrowing due to prevertebral soft tissue swelling after surgery of the anterior cervical spine and their clinical significances using plain cervical X-ray images. Methods : Twenty-four patients undergoing anterior cervical spine surgery were reviewed from January 2004 to December 2005. Postoperatively, in daily basis, lateral radiograph of the neck was obtained in neutral position. We measured the upper airway diameter above and below the epiglottis level and prevertebral soft tissue diameter every day for a week and finally 2 weeks after surgery using their simple lateral cervical X-ray films. Results : Both airway narrowing and prevertebral soft tissue swelling were maximum in postoperative 2 days, and decreased rapidly in postoperative 7 days. Airway narrowing was aggravated postoperatively but slowly decreased as prevertebral soft tissue swelling diminished. But, the severity of airway narrowing showed no clinical correlations with clinical symptom and radiologic severity. Conclusion : Not all patients who show severe airway narrowing and prevertebral soft tissue swelling on their plain cervical X-ray film complain respiratory insufficiency. But, the patients with undergoing anterior cervical spine surgery should be monitored carefully for respiratory insufficiency, especially during several days following operation because both airway narrowing and prevertebral soft tissue swelling become peak at postoperative 2-3 days.

• The Korean Journal of Pain
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• 제23권3호
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• pp.211-214
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• 2010

Spontaneous retropharyngeal hematoma is rare and difficult to diagnosis early. A 23-year-old male spontaneously developed acute onset of neck pain, limitation of neck motion, and mild dysphagia. Magnetic resonance imaging demonstrated blood products in prevertebral space from C2 to C4, suggesting a diagnosis of retropharyngeal hematoma. We report a rare case of spontaneous retropharyngeal hematoma causing neck pain.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.12-17
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• 2014

Objective : Anterior cervical discectomy and fusion (ACDF) is often complicated by subsidence, pseudoarthrosis, kyphosis, and graft donor site morbidities. To decrease the occurrence of these complications, various types of cages have been developed. We designed this retrospective study to analyze and compare the efficacy and outcomes of ACDF using double cylindrical cages (DCC) (BK Medical, Seoul, Korea) versus an anterior cervical plating system with autogenous iliac crest grafts. Methods : Forty-eight patients were treated with autograft and plating (plate group), and 48 with DCC group from October 2007 to October 2011. We analyzed construct length, cervical lordotic curvarture, the thickness of the prevertebral soft tissue, segmental instability, and clinical outcomes. Results : There were no significant differences between the two groups with regard to the decrease in construct length or cervical lodortic curvature at the 3-, 6-, and 12-month follow-ups. The prevertebral soft tissue was thinner in the DCC group than the plate group immediately after surgery and at the 3-, 6-, and 12-month follow-ups. The difference in interspinous distance on flexion-extension was shorter in the plate group than the DCC group at the 3- and 6-month follow-ups. However, there was no significant difference in this distance between the two groups at the 12-month follow-up. Conclusion : A double cylindrical cage is a good alternative for fusion in patients with cervical degenerative diseases; the surgical method is relatively simple, allows good synostosis, has less associated prevertebral soft tissue swelling, and complications associated with autografting can be avoided.

• 대한기관식도과학회지
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• 제9권1호
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• pp.96-100
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• 2003

Retrophayngeal hematomas frequently develop in patients who had cervical vertebra fracture. The hematoma develops in the space between buccopharyngeal fascia and prevertebral fascia. But it rarely causes severe airway obstruction. We recently treated a patient who had dyspnea and dysphagia due to a retropharyngeal hematoma without any significant trauma history. First, tracheostomy was performed to maintain the airway. Then, incision and drainage was done under suspension laryngoscope. This case shows the fact that a retropharyngeal hematoma can result in severe airway obstruction even after a minor trauma.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.103-107
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• 2014

Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

• Investigative Magnetic Resonance Imaging
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• 제22권4호
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• pp.272-276
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• 2018

Extra-articular tenosynovial giant cell tumor (TS-GCT) in retropharyngeal space is a rare case. We found only two case reports in the literature, in which one was located in retropharynx or prevertebral space of the cervical spine. We describe a rare case of TS-GCT in the retropharynx, which was initially misdiagnosed as oropharyngeal cancer. Furthermore, we want to assure that extraarticular diffuse type TS-GCT should be considered in the differential diagnosis of lesions showing low signal intensity in MRI scan.

• Journal of Trauma and Injury
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• 제35권2호
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• pp.115-117
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• 2022

"Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

• Korean Journal of Radiology
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• 제2권4호
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• pp.231-234
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• 2001

The authors describe a rare case of inflammatory pseudotumor involving the clivus, where a soft tissue mass lesion, with extension into the prevertebral retropharyngeal space and the cavernous sinuses, was detected by CT and MRI. The mass resembled a malignant tumor or aggressive infectious lesion, and the final diagnosis of inflammatory pseudotumor was a diagnosis of exclusion, decided after histopathological examination.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.716-725
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• 2023

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.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.304-307
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• 2015

Only a few cases of anterior longitudinal ligament (ALL) injury related with retropharyngeal hematoma without fracture have previously been reported. The treatment of choice for retropharyngeal hematoma is generally considered to be conservative care, but we believe that early surgery of this pathology would be better in certain situations. Here, we describe two cases with life-threatening large retropharyngeal hematomas related with ALL injuries and operated on at an early stage. Two previously healthy patients visited the emergency room with neck pain and dyspnea after falling. Serious neck swelling was observed and lateral neck X-ray showed severe widening of the prevertebral space. Due to dyspnea progression, emergency endotracheal intubation was performed. Although there was no primary cause of the retropharyngeal hematoma on preoperative examination, ALL tearing was intraoperatively confirmed during early surgery. The in-hospital evolutions of the patients were favorable after surgery. We should bear in mind the possibility of ALL injury and perform early surgery where possible given the earlier convalescence and good prognosis.