Late Infection from Anterior Cervical Discectomy and Fusion after Twenty Years

Jin, Sung-Won; Kim, Se-Hoon; Choi, Jong‐il; Ha, Sung-Kon; Lim, Dong-Jun

doi:10.14245/kjs.2014.11.1.22

Cited by 14 publications

(18 citation statements)

References 12 publications

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“…A thorough understanding of the VA and its relation to the bony structures of cervical vertebra is essential. Although morphometric analyses of the relationship of VA with the surrounding bony structures have been published in literatures [ 1 - 10 ], the scope of these publications is limited. Most of these reports were based on cadaveric studies in a small number of subjects [ 1 - 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Study of the Transverse Foramen in the Subaxial Cervical Spine in Korean Patients With Degenerative Changes: An Anatomical Note

Malla¹,

Kim

Won

et al. 2018

Neurospine

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Background/AimsThe purpose of this study was to provide anatomical data on the dimensions and location of the subaxial transverse foramen (TF) in relation to surgical landmarks routinely used during anterior cervical procedures. MethodsA total of 116 patients who underwent preoperative computed tomography (CT) evaluations for degenerative cervical disease were enrolled. Axial and coronal CT images of the cervical vertebrae from C3 to C6 were analyzed to measure interforaminal distance, the TF distance from the anterior and posterior vertebral body margin, TF dimensions, and the TF medial margin from the tip and medial margin of the uncus. Comparative and correlative analyses were also performed according to age, body mass index (BMI), and sex. ResultsAll measurement values in male patients were larger than those in their female counterparts. The interforaminal distance gradually increased from C3 to C6. The distance of the TF medial margin from the tip of the uncus was found be above approximately 3 mm in all vertebrae except C6. Correlation analysis revealed that age had a significant negative relationship with the transverse diameter of TF. In contrast, BMI had a significant positive correlation with interforaminal distance. Moreover, the distances of the TF medial margin from the tip and medial margin of the uncus showed strong negative correlations with age. ConclusionUseful morphometric data were obtained that may help the operating surgeon to avoid vertebral artery injury. The safe distance from the tip of the uncus to the TF medial margin was found to be approximately 3 mm, and this distance should not be violated during lateral decompression. In addition, this value may decrease with age.

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Section: Introductionmentioning

confidence: 99%

Study of the Transverse Foramen in the Subaxial Cervical Spine in Korean Patients With Degenerative Changes: An Anatomical Note

Malla¹,

Kim

Won

et al. 2018

Neurospine

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“…In many studies, post-operative infection usually occur in the first 4 weeks after surgery but late superficial or deep infections may occur even after 1 year from surgery [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Experience in the management of post-operative spinal infection

Eshra

2019

Egypt J Neurol Psychiatry Neurosurg

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Background data: Post spinal surgery infection is not uncommon. It is considered as one of the most annoying complication following surgery on the spine. The major burdens of post spinal surgery infection are time and money consuming. Infections have a considerable effect on post-operative morbidity and mortality. Purpose: The aim of this study was to identify the possible risk factors, preventive measures, diagnostic tools and the ideal management procedures. Study design: Retrospective study. Patients and methods: This is a retrospective study which was carried out on 35 patients operated upon (either primary or revision) for variable spinal lesions from 2006 till 2016 and complicated by post spinal surgery infection. No patient was operated upon for primary pre-existing spinal infection or congenital lesions. Patients were operated upon by same surgeon in the same hospital. On presentation, the patients were diagnosed to have post-operative infection by clinical examination, laboratory and radiological investigations. All patients were re-admitted to the hospital where the proper management was done. Results: Most of cases were associated with pre-operative risk factors and intra or post-operative complications. Cervical disc prolapse (8 patients) was the most common lesion in the cervical region group, whereas lumbar disc prolapse (12 patients) was the most common lesion in lumbar group. Six patients suffered from complications (durotomy in 5 patients and right common iliac artery injury in one patient). Superficial infection was encountered in 12 patients and deep infection was diagnosed in 19 patients, whereas combined infection was diagnosed in 4 patients. Surgical management that needed general anesthesia was provided to 22 patients whereas conservative management was provided to 13 patients. Out of 35 cases, only one patient died from the complications of infection. Conclusion: Post spinal surgery infection is a devastating complication that needs multi-modalities for prevention and control. Neutralization of the pre-operative risk factors can dramatically reduce the post-operative infections. Once diagnosed, the patients with infection must be hospitalized and extensive management should be applied.

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“…Anterior cervical discectomy/corpectomy and fusion surgery is most commonly performed cervical spine procedures in last few decades. [ 10 14 ] This procedure is performed using the anterior surgical approach described by Cloward and Smith-Robinson. [ 1 2 15 ] The common indications for these procedure include degenerative cervical disc disease, trauma, and tumors.…”

Section: Discussionmentioning

confidence: 99%

“…With recent advances in better implant designs and fixation techniques and post-operative rehabilitation the successful outcome (early spine stability, early patient mobilization, improved union rate and reduced hospital stay) has been markedly improved. [ 3 4 14 ]…”

Section: Discussionmentioning

confidence: 99%

Late prevertebral abscess with sinus following anterior cervical corpectomy and fusion

et al. 2015

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Anterior cervical discectomy/corpectomy and fusion is performed in degenerative, traumatic and neoplastic etiologies of the cervical spine. This procedure is highly successful and associated with fewer complications. The rates of early and late postoperative infection have been reported to be between 0.1% and 1.6%, the late infections are being very rare. We report a rare case of a 30-year-old HIV negative, non-diabetic male who developed a late prevertebral cervical abscess with discharging sinus over posterior triangle of neck 3 years after an anterior cervical C6 corpectomy with fibular grafting and buttress screw fixation performed elsewhere for traumatic fracture C6 vertebra. The abscess was drained using radical neck dissection approach with complete excision of sinus track and removal of the infected implant. On culture, the organism was found to be beta-hemolytic streptococci, for which appropriate antibiotics were administered postoperatively. The sinus tract completely healed in 3 months time. Late infection as a complication of anterior cervical spine surgeries is rare and is associated with esophageal perforation, implant migration, seeding of the deep prevertebral space with oropharyngeal flora, or from surgical site/bacteremia or with Zenker's diverticulum. Few cases have been reported till date, but none have presented with a sinus tract. We present a case of delayed prevertebral abscess after cervical spine instrumentation that followed abnormal path causing sinus track to be developed in the site (the posterior triangle of the neck) other than previous incision site. Exploring both triangles of the neck using radical neck dissection approach was essential for complete excision of sinus track, removal of screw and debridement.

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Late Infection from Anterior Cervical Discectomy and Fusion after Twenty Years

Cited by 14 publications

References 12 publications

Study of the Transverse Foramen in the Subaxial Cervical Spine in Korean Patients With Degenerative Changes: An Anatomical Note

Study of the Transverse Foramen in the Subaxial Cervical Spine in Korean Patients With Degenerative Changes: An Anatomical Note

Experience in the management of post-operative spinal infection

Late prevertebral abscess with sinus following anterior cervical corpectomy and fusion

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