An anatomical study of the pharyngeal plexus: Application to avoiding postoperative dysphagia following anterior approaches to the cervical spine

2021 ◽  
Author(s):  
Joe Iwanaga ◽  
Emre Yilmaz ◽  
Marios Loukas ◽  
Lu Xu ◽  
Aysun Uz ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Anatomical Study ◽  
Postoperative Dysphagia ◽  
Pharyngeal Plexus

Is congenital bony stenosis of the cervical spine associated with lumbar spine stenosis? An anatomical study of 1072 human cadaveric specimens

2012 ◽  
Vol 17 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Navkirat S. Bajwa ◽  
Jason O. Toy ◽  
Ernest Y. Young ◽  
Nicholas U. Ahn
Keyword(s):  
Logistic Regression ◽  
Cervical Spine ◽  
Lumbar Spine ◽  
Linear Regression Analysis ◽  
Large Population ◽  
Positive Association ◽  
Anatomical Study ◽  
Lumbar Stenosis ◽  
Increased Risk ◽  
Tandem Stenosis

Object Congenital cervical and lumbar stenosis occurs when the bony anatomy of the spinal canal is smaller than expected, predisposing an individual to symptomatic neural compression. While tandem stenosis is known to occur in 5%–25% of individuals, it is not known whether this relationship is due to an increased risk of degenerative disease in these individuals or whether this finding is due to the tandem presence of a congenitally small cervical and lumbar canal. The purpose of the present study was to determine if the presence of congenital cervical stenosis is associated with congenital lumbar stenosis. Methods One thousand seventy-two adult skeletal specimens from the Hamann-Todd Collection in the Cleveland Museum of Natural History were selected. The canal area at each level was calculated using a formula that was verified by computerized measurements. Values that were 2 standard deviations below the mean were considered to represent congenitally stenotic regions. Linear regression analysis was used to determine the association between the sum of canal areas at all levels in the cervical and lumbar spine. Logistic regression was used to calculate odds ratios for congenital stenosis in one area if congenital stenosis was present in the other. Results A positive association was found between the additive area of all cervical (that is, the sum of C3–7) and lumbar (that is, the sum of L1–5) levels (p < 0.01). A positive association was also found between the number of cervical and lumbar levels affected by congenital stenosis (p < 0.01). Logistic regression also demonstrated a significant association between congenital stenosis in the cervical and lumbar spine, with an odds ratio of 0.2 (p < 0.05). Conclusions Based on the authors' findings in a large population of adult skeletal specimens, it appears that congenital stenosis of the cervical spine is associated with congenital stenosis of the lumbar spine. Thus, the presence of tandem stenosis appears to be, at least in part, related to the tandem presence of a congenitally small cervical and lumbar canal.

A Correlation Analysis Between Postoperative Dysphagia and Change of C2-C7 Angle after Anterior Cervical Spine Surgery

2021 ◽  
Author(s):  
Jie Yu ◽  
Xiaohui Tao
Keyword(s):  
Cervical Spine ◽  
Spinal Surgery ◽  
Cervical Disc ◽  
Cervical Lordosis ◽  
Postoperative Dysphagia ◽  
Cervical Spine Surgery ◽  
Cervical Disc Replacement ◽  
Anterior Cervical Spine Surgery ◽  
Angle Change

Abstract Background. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities in clinical practice. Studies suggest that excessive O-C2 angle change at occipital-cervical fusion causes the oropharyngeal volume reduction leading to severe dysphagia and even respiratory distress after operation. However, rare study has accessed the impact of C2-C7 angle change on the occurrence of dysphagia after anterior cervical spinal surgery. Methods. From June 2007 to May 2010, A total of 198 patients was treated with anterior cervical decompression and plate fixation and 12 months follow-up was completed in 172 patients. Within the same session, a total of 154 patients underwent anterior cervical disc replacement and at least 1-year follow-up was completed in 98 patients. All 270 patients who participated in this study completed a questionnaire (Bazaz dysphagia questionnaire) after telephone follow-up including the onset and time of appearance of dysphagia, symptom relief, treatment plan and so on. To determine whether excessive cervical lordosis change (change of C2-C7 angle) and other risk factors were associated with the dysphagia symptom, all patients were divided into the dysphagia group and the control group, followed over 12 months.Results. The results showed that 12.8% presented with postoperative dysphagia in anterior cervical discectomy and fusion (ACDF) group and 5.1% in cervical disc replacement (CDR) group. According to the regression equation, the excessive change of C2-C7 angle can significantly increase the incidence rate of postoperative dysphagia. The incidence rate of postoperative dysphagia in patients whose C2-C7 angle change more than 5 degree was significantly greater than patients less than 5 degree. Sex, age, BMI, operation time, blood loss, surgery approach (anterior/posterior), revision ratio, the number of surgical segments, the highest surgical segment, and C3 segment included or not cannot affect the occurrence of dysphagia. Conclusions. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities. Cervical lordosis change is an important influencing factor on the occurrence of dysphagia after anterior cervical spine surgery.

Analysis of the uncinate processes of the cervical spine: an anatomical study

2012 ◽  
Vol 16 (4) ◽  
pp. 402-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Olivia J. Rompala ◽  
Ketan Verma ◽  
Martin M. Mortazavi ◽  
Brion Benninger ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Anatomical Study ◽  
Axial Rotation ◽  
Intervertebral Discs ◽  
Uncinate Process ◽  
Surgical Approaches ◽  
Intervertebral Foramen ◽  
Facet Joints ◽  
Vertebral Level ◽  
Arthritic Changes

Object Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this region's morphological features. Methods Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. Results The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. Conclusions A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.

Tracheal Traction Exercise Reduces the Occurrence of Postoperative Dysphagia After Anterior Cervical Spine Surgery

Spine ◽  
2012 ◽  
Vol 37 (15) ◽  
pp. 1292-1296 ◽  
Author(s):  
Zhi Chen ◽  
Xianzhao Wei ◽  
Fengning Li ◽  
Ping He ◽  
Xuan Huang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Postoperative Dysphagia ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

The impact of automatic retractors on the esophagus during anterior cervical surgery: an experimental in vivo study in a sheep model

2009 ◽  
Vol 11 (5) ◽  
pp. 547-554 ◽  
Author(s):  
Halit Çavuşoğlu ◽  
Cengiz Tuncer ◽  
Canan Tanik ◽  
Zihni Mutlu ◽  
Ebruhan Zengin ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Muscularis Propria ◽  
Histochemical Staining ◽  
Histopathological Study ◽  
Postoperative Dysphagia ◽  
Sheep Model ◽  
Cervical Spine Surgery ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Object Postoperative dysphagia is a well-recognized complication of the anterior surgical approach to the cervical spine. However, its incidence and etiology remain unknown. The aim of this study was to investigate the impact of automatic retractor use on the esophagus and to describe the related pathological changes that might occur during cervical spine surgery. Methods A single-level cervical discectomy was performed via an anterior approach in 16 skeletally mature female sheep. Continuous retraction was applied with an automatic retractor system during surgery. The sheep model was chosen because of anatomical similarities to the human esophagus. The esophageal tract in every animal was examined using contrast radiographic examination. Eight animals were killed 3 days after the operation (Group 1). The remaining sheep were killed 4 weeks after the operation (Group 2). The esophagi were removed for histopathological study, which was performed using H & E and Masson trichrome staining. The changes in esophageal innervation were examined with nicotinamide adenine dinucleotide diphosphate–diaphorase histochemical staining. Results Only 1 animal (a Group 1 sheep) demonstrated any postoperative radiographic abnormality. In Group 1 sheep, histopathological study of the esophagi at the treated level revealed edema between the muscular fibers in the outer longitudinal and inner circular layers of the muscularis propria. At some points, obvious signs of vascular congestion, vascular damage, and inflammation were observed. In the Group 2 animals, there was mild-to-moderate fibrosis extending from the outer surface of the esophagus to the longitudinal layers of the muscularis propria in the area to which retraction had been applied. Enzyme-histochemical staining revealed the presence of normal myenteric plexus and ganglion cells, and nitrergic innervation in all parts of the esophagus wall. Conclusions The results of this study demonstrate that direct pressure induced by the medial retractor blade on the esophagus wall leads to local injury. Postoperative dysphagia in human patients who have undergone anterior cervical spine surgery could be a clinical manifestation of this phenomenon.

Postoperative Dysphagia in Anterior Cervical Spine Surgery

Spine ◽  
2010 ◽  
Vol 35 (Supplement) ◽  
pp. S76-S85 ◽  
Author(s):  
Lee H. Riley ◽  
Alexander R. Vaccaro ◽  
Joseph R. Dettori ◽  
Robin Hashimoto
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Postoperative Dysphagia ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

The pharyngeal plexus: an anatomical review for better understanding postoperative dysphagia

2020 ◽  
Author(s):  
Santiago Gutierrez ◽  
Joe Iwanaga ◽  
Przemyslaw Pekala ◽  
Emre Yilmaz ◽  
William E. Clifton ◽  
...  
Keyword(s):  
Postoperative Dysphagia ◽  
Pharyngeal Plexus

scholarly journals Differences of the Morphology of Subaxial Cervical Spine Endplates between Chinese and White Men and Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Qi Yao ◽  
Peng Yin ◽  
Kamran Khan ◽  
Tsung-Yuan Tsai ◽  
Jing-Sheng Li ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Anatomical Study ◽  
White Men ◽  
Measuring System ◽  
Computed Tomography Imaging ◽  
Men And Women ◽  
Subaxial Cervical Spine ◽  
Digital Measuring System

Objective. The aim of this comparative anatomical study was to specifically investigate endplate morphology differences between Chinese and White men and women. Materials and Methods. Three-dimensional cervical endplate models were constructed using computed tomography imaging of 41 healthy Chinese and 24 White subjects. The morphologic measurements of cervical endplate included linear parameters (EPWu: upper endplate width; EPDu: upper endplate depth; EPWl: lower endplate width; and EPDl: lower endplate depth) and area parameters with a digital measuring system. Results. All linear parameters showed a constant increase from C3 to C7 except for EPDl in both the Chinese and the White subjects. An increase trend was observed on area parameters in both Chinese and White subjects. The ratio of EPWl/EPDl was smaller in Chinese females than in White females at C3, C4, and C6 levels (P<0.05). The ratio of EPWl/EPDl was significantly different between the Chinese and White men at C4-5 levels (P<0.05). Conclusions. Our data indicates that the morphology of subaxial cervical spine endplates between Chinese and White men and women is different in most of the linear and area parameters. This information could provide guidelines for the design of CDA implants and the improvement of surgical techniques.

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