scholarly journals PARTICULARITIES IN TREATMENT OF ESOPHAGEAL PERFORATION AFTER CERVICAL SPINE FUSION EXPERIENCE OF TREATMENT OF 24 PATIENTS

2017 ◽  
Vol 8 (2) ◽  
pp. 61-71
Author(s):  
A N Pogodina ◽  
A A Green ◽  
D S Kasatkin ◽  
A K Kaikov ◽  
A S Lvov ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Anterior Cervical Fusion ◽  
Cervical Fusion ◽  
Double Row ◽  
Golden Standard ◽  
Repeated Surgery ◽  
Clinically Significant ◽  
Cervical Spine Fusion ◽  
Access Surgery ◽  
Adequate Decompression

The aim of the study is to specify the causes, peculiarities of the damage and the tactics of treating patients with clinically significant damages to the esophagus after the anterior cervical fusion or in combination with it.Material and methods: medical treatment of 24 patients in Sklifosovsky Emergency Research Institute with the damage to the esophagus after the front access surgery of the cervical spine during the period of 2003-2016 was analyzed.Results: we succeeded to restore or save the support ability of the spine for all patients and at the same time to take away the infected transplants, and, if necessary, to make adequate decompression of neurovascular entities of the spine column and fixation of the verbal-motor segment. 21 patients underwent conserving surgery in the cervical esophagus with its suturing with the double-row suture. 2 patients had failure of seams in the esophagus and they underwent a repeated surgery of suturing its defect. 2 patients underwent organodetrital surgeries. One patient died. Conclusion: damages to the esophagus after anterior cervical fusion or in combination with it are rare complications. That is why it is impossible to gain much experience in treating of such patients in only one clinic. In this case all publications on this topic are of great interest. Due to unsatisfactory results of the conservative therapy we should consider surgical treatment in general hospitals with the participation of a multidisciplinary brigade the golden standard.

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

scholarly journals Use of Allogenic Mesenchymal Cellular Bone Matrix in Anterior and Posterior Cervical Spinal Fusion: A Case Series of 21 Patients

2017 ◽  
Vol 11 (3) ◽  
pp. 454-462 ◽  
Author(s):  
Srikanth Naga Divi ◽  
Mark M. Mikhael
Keyword(s):  
Cervical Spine ◽  
High Risk ◽  
Bone Matrix ◽  
Case Series ◽  
Leisure Activity ◽  
Spine Fusion ◽  
Cervical Fusion ◽  
Medical Comorbidities ◽  
Cervical Spine Fusion ◽  
Cellular Bone

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To report our early experience using allogenic mesenchymal cellular bone matrix (CBM) products in cervical spine fusion.</p></sec><sec><title>Overview of Literature</title><p>Multi-level cervical fusions have historically yielded lower fusion rates than single level fusions, especially in patients with high risk medical comorbidities. At this time, significant literature in cervical fusion outcomes with this cellular allograft technology is lacking.</p></sec><sec><title>Methods</title><p>Twenty-one patients underwent either multilevel (3 or 4 level) anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, or posterior cervical fusion. ViviGen (DePuy Synthes Spine, Raynham, MA, USA), an allogenic bone matrix product, was used in addition to standard instrumentation. Radiographic evaluation was performed at 2 weeks, 12 weeks, 24 weeks and 1 year postoperative. Visual analog scale (VAS) and neck disability index (NDI) scores along with return to work and leisure activity were recorded.</p></sec><sec><title>Results</title><p>At 6 months postoperative, all patients had radiographic evidence of bone fusion regardless of age or medical comorbidities. All patients reported subjective improvement with a mean decrease in VAS from 8.3 to 1.5 and a mean decrease in NDI from 40.3% to 6.0% at 1 year. All patients also returned to work and/or regular leisure activity within 3 months.</p></sec><sec><title>Conclusions</title><p>Twenty-one patients undergoing high-risk anterior and posterior cervical spine fusion, with the use of a commercially available mesenchymal CBM product, went on to radiographic fusion and all had improvement in subjective outcomes. While further effort and research is needed to validate its widespread use, this study shows favorable use of CBM in cervical fusion for high-risk cases.</p></sec>

Monitoring of blood parameters following anterior cervical fusion

2000 ◽  
Vol 92 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Steffen K. Rosahl ◽  
Alireza Gharabaghi ◽  
Peter-Michael Zink ◽  
Madjid Samii
Keyword(s):  
Cervical Spine ◽  
Cell Count ◽  
Postoperative Period ◽  
White Cell Count ◽  
Anterior Cervical Fusion ◽  
Anterior Fusion ◽  
Cervical Fusion ◽  
Content Type ◽  
Cervical Spine Surgery ◽  
Fine Print

Object. Both C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) were measured prospectively in 51 cases in which uncomplicated cervical anterior fusion was performed. The object of the authors was to quantify the differences in the responses of these parameters recorded in the immediate postoperative period and to determine factors influencing their course. Methods. Nineteen one-level, 23 two-level, and nine three-level procedures for disc herniation and degenerative disease of the cervical spine were performed in 22 female and 29 male patients (mean age 49.2 years). Blood samples were obtained 1 day before as well as on 10 consecutive days and 3 months following anterior cervical fusion. Serum CRP level was measured using a fluorescence polarization immunoassay and ESR was determined from the same samples. Operative time, the number of blood transfusions, and drugs administered in the postoperative period were recorded. In addition, hemoglobin, hematocrit, red blood cell count, platelet count, white cell count, and axillary body temperature were checked daily. Conclusions. Monitoring of CRP level is superior to that of ESR for early detection of infections after cervical spine surgery. Although CRP was not related to any of the factors that have been proposed to explain its peak value variance in previous studies, individual acute-phase protein metabolism response to tissue affection appears to be a more decisive element in this respect.

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