• Title/Summary/Keyword: Cervical disc

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Management of Postoperative Intra-Abdominal Hypertension in a Dog Undergoing Cervical Disc Surgery

  • Kim, Dongseok;Choi, Geonho;Lee, Sang-Kwon;Lee, Kija;Lee, Won-Jae;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Min
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.277-281
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    • 2022
  • The dog with tetraplegia was presented for magnetic resonance imaging and cervical ventral slot decompression. Intra-abdominal pressure (IAP) was measured every hour after surgery, along with respiratory rate, heart rate, and arterial pressure. Three hours after surgery, abdominal distension with agitation and respiratory distress were observed, and IAP rose to 12 mmHg, indicating mild intra-abdominal hypertension (IAH). Additional fentanyl and ketamine CRI did not alleviate IAH and acepromazine (0.01 mg/kg, IV) was administered to alleviate the agitation and respiratory distress. After acepromazine administration, the agitation subsided and IAP dropped to 4 mmHg. During the next 24 hours, the patient's vital signs and IAP remained stable, with normal urine output. This case report suggests the possibility of postoperative IAH monitoring in dogs. However, considering the nature of a single surgical case of cervical ventral slot, further study is required for indication of IAH monitoring.

Comparison of Fusion with Cage Alone and Plate Instrumentation in Two-Level Cervical Degenerative Disease

  • Joo, Yong-Hun;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.342-346
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    • 2010
  • Objective : This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods : Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. Results : VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p= 0.654). Conclusion : In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park;Sang Mook Kang;Yu Deok Won;Myung-Hoon Han;Jin Hwan Cheong;Byeong-Jin Ha;Je Il Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.716-725
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    • 2023
  • Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

A Study on Clinical Findings about Vertebral Disease Diagnosed with MRI (MRI로 진단된 척추질환의 임상적 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.29 no.3
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    • pp.157-165
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    • 2006
  • In order to analyze clinical characteristics like sex- and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging(MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE(fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics(such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions : 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra(65.5%), which was followed by cervical vertebrae(27.3%) and thoracic vertebrae(7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows : 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

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A Case of Intradiscal Oxygen-ozone Injection Therapy for Cervical Herniated Intervertebral Disc in a Dog (개에서 탈출된 경추디스크에 대한 디스크내 오존가스 주입 치료)

  • Jang, Ha-Young;Lee, Jun-Sub;Lee, Bo-Ra;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.273-275
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    • 2009
  • A 6-year-old castrated male Shih-tzu was presented because of a 1-month history of progressive tetraplegia. On the basis of the findings of neurological examination, radiographs and magnetic resonance imaging, herniated intervertebral disc of C4-C5, C5-C6 and C6-C7 compressed spinal cord. The oxygen-ozone was intra-operatively injected into the C4-C5 and C6-C7 intervertebral disc and a ventral decompression performed at C5-C6 intervertebral space. Immediately after the surgery, neck pain was disappeared and three weeks after surgery, there was complete resolution of the neurological deficits with normal gaits. On magnetic resonance images at 2-month after surgery, herniated disc materials of C5-C6 and C6-C7 were completely removed and that of C4-C5 remarkably reduced. Consequently decompression which was performed at all of the three lesions resulted in good clinical outcome without additional internal fixation for minimizing postoperative instability.

A Clinical Study of Carthmi-Flos Herbal Acupuncture Treatment on Cervical Disc Herniation Patients (경추추간판(頸椎椎間板) 탈출증(脫出症) 환자(患者)의 홍화약침치료(紅花藥鍼治療)에 대한 임상적(臨床的) 고찰(考察))

  • Yeom, Seung-Chul;Kim, Do-Ho;Ryu, Sung-Won;Kim, Dae-Joong;Cho, Nam-Geun;Yun, Ju-Young;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.23 no.3
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    • pp.21-35
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    • 2006
  • Objectives : Herniation of Nucleus Pulposus(HNP) of Cervical is the most important reason that causes Cervical pain. The aim of this study is to investigate the effectiveness of Carthmi-Flos Herbal acua-acupuncture therapy for Cervical disc Herniation patients. Methods : To evaluate the effectiveness of Carthmi-Flos Herbal acua-Acupuncture Therapy, 20 patients were treated by Carthmi-Flos Herbal acua-acupuncture therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale (QVAS). Results & Conclusion : 1. As a objectivity treatment record, they test treatment record good 35%, fair 35%, excellent 30%. 2. After Carthmi-Flos acua-acupuncture therapy, pain rate changed from 8.80 to 5.40 3. By the results which puts out the statistics in sex , a pain rate of male changed from 8.57$({\pm}1.51)$ to 2.71$({\pm}2.63)$, a pain rate of female 8.92$({\pm}0.95)$ to 3.77$({\pm}2.09)$. Intentional difference is none as a therapy. 4. By the results which puts out the statistics in age, after forties changed from 9.07$({\pm}0.88)$ to 3.80$({\pm}2.43)$ and before forties changed from 8.00$({\pm}1.58)$ to 2.20$({\pm}1.30)$. Intentional difference is none as a therapy. 5. By the results which puts out the statistics in Duration, pain rate of the acutest group changed from 8.36$({\pm}1.12)$ to 2.18$({\pm}1.08)$, pain rate of the subacute group changed from 9.80$({\pm}0.45)$, to 5.20$({\pm}2.68)$, pain rate of the chronic group changed from 8.67$({\pm}1.53)$ to 3.33$({\pm}1.53)$. Intentional difference is none as a therapy. 6. By the results which puts out the statistics in the reading of Lumbar MID, pain rate of the Bulging type changed from 9.00$({\pm}1.05)$ to 4.30$({\pm}2.67)$, pain rate of the Protruded type changed from 8.50$({\pm}1.00)$, to 3.50$({\pm}1.29)$, pain rate of the Extruded type changed from 6.00 to 1.00, pain rate of the Mixed type changed from 9.20$({\pm}0.84)$ to 2.00$({\pm}1.23)$, Intentional difference is none as a therapy.

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Vertebral Distraction during Anterior Cervical Discectomy and Fusion Causes Postoperative Neck Pain

  • Ha, Seung Man;Kim, Jeong Hoon;Oh, Seung Hun;Song, Ji Hwan;Kim, Hyoung Ihl;Shin, Dong Ah
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.288-292
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    • 2013
  • Objective : Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods : This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 $kgf{\cdot}cm$) and the low torque group (distraction force${\leq}6kgf{\cdot}cm$) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results : The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days ($y=0.99{\times}-1.1$, $r^2=0.82$; $y=0.77{\times}-0.63$, $r^2=0.73$, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively ($3.1{\pm}1.3$, $2.6{\pm}1.0$ compared with $6.0{\pm}0.6$, $4.9{\pm}0.8$, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion : Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 $kgf{\cdot}cm$.

An Analysis of Treatment and Economic Evaluation on the Part of Cervical HIVD Inpatients at Korean Medicine Hospital (한방병원에 입원한 경추 추간판 탈출증 환자의 치료 및 경제성 평가 연구)

  • Lee, Hyun-Jae;Jahng, Sun-Jeong;Heo, Dong-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.159-175
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    • 2013
  • Objectives Herniated Intervertebral Disc of C-spine is one of the most common diseases that causes posterior neck pain. This study was designed to analyze the general distribution and hospital cost by day and case of Korean medical treatment for Cervical Herniated Intervertebral Disc (HIVD). Methods The 132 impatients for treatment of HIVD were analyzed according to the distribution of sex, age, the duration of HIVD, the contributory factors, the Clinical grade at admission, the clinical findings at admission, the duration of hospitalization, the clinical grade at admission and the hospital cost per day and case. Results 1) The total hospital cost per case averaged 1,985,600 Won, which was consisted of room charge 584,044 Won (29.41%), performance fee 511,463 Won (25.76%), herbal medication 381,517 Won (19.21%), Korean medical physiotherapy 296,310 Won (14.92%), food expenses 199,997 Won (10.07%) in order. 2) The total hospital cost per day averaged 137,285 Won, which was consisted of room charge 39,036 Won (28.43%), performance fee 33,594 Won (24.47%), herbal medication 30,642 Won (22.32%), food expenses 12,870 Won (9.37%), and the average duration of hospitalization was 15.1 days. 3) There was statistically significant difference in the consultation fee, room charge, and herbal medication on the part of sex. 4) There was statistically significant difference not only in the performance and consultation on the part of duration of hospitalization but also the in the duration of average duration of hospitalization. 5) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical findings. 6) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of duration of HIVD. 7) There was statistically significant difference in the Korean medical physiotherapy and herbal medication on the part of clinical outcome. 8) There was not only statistically significant difference in the performance, but also in the herbal medication on the part of clinical grade at admission. Conclusions This study provides plenty of information to design out the specific terms of Korean medical expenses of Cervical HIVD inpatients hospitalized at Korean medicine hospital.