1
|
von Glinski A, Elia C, Yilmaz E, Frieler S, Ishak B, Anand MK, Iwanaga J, Abdul-Jabbar A, Oskouian RJ, Tubbs RS, Chapman JR. Space-Occupying Lesions of the Retropharyngeal Space: An Anatomical Study With Application to Postoperative Retropharyngeal Hematomas. Global Spine J 2021; 11:704-708. [PMID: 32875906 PMCID: PMC8165929 DOI: 10.1177/2192568220922192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
STUDY DESIGN Cadaver study. OBJECTIVE The retropharyngeal space's (RPS's) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation. METHODS Five fresh-frozen cadavers were dissected in the supine position. A digital manometer and a 20 Fr Foley catheter were inserted into the RPS via an anterolateral approach. While inflating the Foley catheter, the position of the esophagus/trachea was documented using fluoroscopy, and the retropharyngeal pressure was measured. We quantified the volume required to deviate the esophagus/trachea >1 cm from its original position using fluoroscopy. We also recorded the volume required to cause a visible change to the normal neck contour. RESULTS A mean volume of 12.5 mL (mean pressure 1.50 mm Hg) was needed to cause >1 cm of esophageal deviation. Tracheal deviation was encountered at a mean volume of 20.0 mL (mean pressure of 2.39 mm Hg). External visible clinical neck contour changes were apparent at a mean volume of 39 mL. CONCLUSION A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.
Collapse
Affiliation(s)
- Alexander von Glinski
- Swedish Medical Center, Seattle, Washington, DC, USA,Seattle Science Foundation, Seattle, Washington, DC, USA,Ruhr University Bochum, Bochum, Germany,Swedish Hospital, Seattle, Washington, DC, USA,Alexander von Glinski, Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA 98122, USA.
| | - Christopher Elia
- Swedish Medical Center, Seattle, Washington, DC, USA,Seattle Science Foundation, Seattle, Washington, DC, USA
| | | | - Sven Frieler
- Swedish Medical Center, Seattle, Washington, DC, USA
| | - Basem Ishak
- Swedish Medical Center, Seattle, Washington, DC, USA,Seattle Science Foundation, Seattle, Washington, DC, USA
| | | | - Joe Iwanaga
- Seattle Science Foundation, Seattle, Washington, DC, USA,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | - Amir Abdul-Jabbar
- Swedish Medical Center, Seattle, Washington, DC, USA,Seattle Science Foundation, Seattle, Washington, DC, USA
| | - Rod J. Oskouian
- Swedish Medical Center, Seattle, Washington, DC, USA,Seattle Science Foundation, Seattle, Washington, DC, USA
| | - R. Shane Tubbs
- Swedish Medical Center, Seattle, Washington, DC, USA,St George’s University, Grenada, West Indies,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | | |
Collapse
|
2
|
Igoumenou VG, Mavrogenis AF, Angelini A, Baracco R, Benzakour A, Benzakour T, Bork M, Vazifehdan F, Nena U, Ruggieri P. Complications of spine surgery for metastasis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 30:37-56. [DOI: 10.1007/s00590-019-02541-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/28/2019] [Indexed: 02/07/2023]
|
3
|
Wang Q, Xing R, Zeng Y. Design and application of subaxial cervical pedicle screw placement guide device. Exp Ther Med 2019; 17:4357-4362. [PMID: 31086571 PMCID: PMC6488976 DOI: 10.3892/etm.2019.7479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 05/11/2018] [Indexed: 11/30/2022] Open
Abstract
In the present study, a novel subaxial cervical pedicle screw placement guide device was designed and developed. In cervical specimens (C3-C7), a pedicle screw was inserted into the left pedicle using the guide device with a keyhole partial laminectomy and tapping technique, and the right pedicle by drilling using the Abumi technique. After removing the pedicle screws, the channel wall of each pedicle screw was probed with a pedicle probe. The vertebral body was then dissociated for direct observation of the screw channel. Among the 10 specimens, 2 of the 50 pedicles (4%) in the guide device group were perforated. Screw placement failed in 8 of 50 pedicles (16%) in the Abumi technique group. Significant differences were observed in the outcomes for the guide device and Abumi technique groups. The subaxial cervical pedicle screw placement guide device developed in the present study decreased the failure rate of pedicle screw placement.
Collapse
Affiliation(s)
- Qiang Wang
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China
| | - Runlin Xing
- Department of Orthopaedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, P.R. China
| | - Yiwen Zeng
- Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China
| |
Collapse
|