New Diagnosis of Obstructive Sleep Apnea Following Anterior Cervical Discectomy Complicated by Rheumatoid Arthritis: A Case Report

Anterior Cervical Discectomy and Fusion: A Hidden Etiology of Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA), a common variant of sleep-disordered breathing, is characterized by repeated complete or partial collapse of upper airways during sleep, leading to oxyhemoglobin desaturations. The obstruction may be iatrogenically induced in patients undergoing Anterior Cervical Discectomy and Fusion (ACDF). Damage to the pharyngeal plexus during the procedure may predispose to a new collapse of the upper airway, and the placement of the hardware for the fusion may lead to further narrowing of the upper airway. Literature does not exist associating this possible etiology prospectively. The association of ACDF and OSA has only been retrospectively documented by Guiilleminault and associates. We are reporting a case of a 49-year-old female who was evaluated pre and post surgery and established the evidence of worsening OSA in a patient who underwent ACDF.

The Many Fronts of Battling Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a breathing disorder during sleep secondary to collapsing upper airways that leads to a significant decrease or a complete cessation of airflow despite an effort to breathe. As the name suggests, an obstruction, likely caused by an inherited narrow airway, is the most common cause. But there are less known factors that may contribute to the worsening of OSA. We present a case of very severe OSA contributed by weight gain, opioid use, and anterior cervical discectomy and fusion (ACDF), in addition to a genetically narrow airway. This case highlights the importance of battling OSA on many different fronts. Our patient eventually was able to stop positive airway pressure (PAP) therapy, once the contributing factors were addressed appropriately.

New Diagnosis of Obstructive Sleep Apnea Following Anterior Cervical Discectomy Complicated by Rheumatoid Arthritis: A Case Report

Obstructive sleep apnea (OSA) is the most common variant of sleep-disordered breathing that often goes undiagnosed. OSA is characterized mainly by anatomical obstruction or partial collapse of upper airways during sleep. The obstruction is multifactorial, and a lesser-known fact is that damage to the pharyngeal plexus during head and neck procedures or placement of hardware in the cervical area can lead to narrowing or collapse of the upper airway. We present such a case of a 59-year-old female who developed new-onset OSA after undergoing anterior cervical discectomy and fusion (ACDF). The severity of OSA worsened with the progression of her rheumatoid arthritis (RA) in the cervical region. This case report aims to raise awareness of such an association among clinicians to enable them to screen appropriate patients for sleep-disordered breathing and treat them accordingly.