頚椎前方手術後の椎体前面軟部組織腫脹は抜管前に予測できる

はじめに：本研究の目的は頚椎前方手術後の椎体前面軟部組織腫脹（PSTS）を経時的に調査，抜管前と抜管後PSTSを比較検討し，抜管前PSTSが抜管後の気道狭窄予測の指標となるかを調査する事である．対象と方法：対象は頚椎前方手術を行い，当院の周術期管理プロトコールを適応した28例とした．頚椎側面レントゲンを用いてC2～C5までの各レベルでPSTSを計測．撮影時期は術前，POD1抜管前（Pre-ex），POD1抜管後（Post-ex），術後2日（POD2），術後6日（POD6）とし，術後の各タイミング，各レベルでの増加率（ΔPSTS［%］）を計測，①ΔPSTSの経時的変化の推移，②Pre-exとPo...

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Published inJournal of Spine Research Vol. 12; no. 9; pp. 1102 - 1109
Main Authors 岩崎, 幹季, 奥田, 眞也, 古家, 雅之, 長本, 行隆, 高橋, 佳史, 道場, 隆博, 上塚, 学, 松本, 富哉
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本脊椎脊髄病学会 20.09.2021
Subjects
椎体前面軟部組織腫脹
気管支鏡
頚椎前方手術
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ISSN1884-7137
2435-1563
DOI10.34371/jspineres.2021-0004

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Abstract はじめに：本研究の目的は頚椎前方手術後の椎体前面軟部組織腫脹（PSTS）を経時的に調査，抜管前と抜管後PSTSを比較検討し，抜管前PSTSが抜管後の気道狭窄予測の指標となるかを調査する事である．対象と方法：対象は頚椎前方手術を行い，当院の周術期管理プロトコールを適応した28例とした．頚椎側面レントゲンを用いてC2～C5までの各レベルでPSTSを計測．撮影時期は術前，POD1抜管前（Pre-ex），POD1抜管後（Post-ex），術後2日（POD2），術後6日（POD6）とし，術後の各タイミング，各レベルでの増加率（ΔPSTS［%］）を計測，①ΔPSTSの経時的変化の推移，②Pre-exとPost-ex，POD2，POD6の相関関係を調べた．結果：ΔPSTSの経時的変化は抜管前から上位頚椎レベルでΔPSTSが大きく，各レベル共にPOD2で最大であった．Pre-ex ΔPSTSと抜管後各レベル，タイミングで中等度，特に中位頚椎ではPOD6まで強い相関関係を認めた．結語：抜管前PSTSが抜管後PSTSの推移予測に有用である事が判明した．
AbstractList はじめに：本研究の目的は頚椎前方手術後の椎体前面軟部組織腫脹（PSTS）を経時的に調査，抜管前と抜管後PSTSを比較検討し，抜管前PSTSが抜管後の気道狭窄予測の指標となるかを調査する事である．対象と方法：対象は頚椎前方手術を行い，当院の周術期管理プロトコールを適応した28例とした．頚椎側面レントゲンを用いてC2～C5までの各レベルでPSTSを計測．撮影時期は術前，POD1抜管前（Pre-ex），POD1抜管後（Post-ex），術後2日（POD2），術後6日（POD6）とし，術後の各タイミング，各レベルでの増加率（ΔPSTS［%］）を計測，①ΔPSTSの経時的変化の推移，②Pre-exとPost-ex，POD2，POD6の相関関係を調べた．結果：ΔPSTSの経時的変化は抜管前から上位頚椎レベルでΔPSTSが大きく，各レベル共にPOD2で最大であった．Pre-ex ΔPSTSと抜管後各レベル，タイミングで中等度，特に中位頚椎ではPOD6まで強い相関関係を認めた．結語：抜管前PSTSが抜管後PSTSの推移予測に有用である事が判明した．
Author 上塚, 学
松本, 富哉
高橋, 佳史
長本, 行隆
岩崎, 幹季
道場, 隆博
奥田, 眞也
古家, 雅之
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References 3) Matsumoto T, Yamashita T, Okuda S, et al: A Detailed Clinical Course Leading to Hypoxic Ischemic Encephalopathy After Anterior Cervical Spine Surgery: A Case Report. JBJS Case Connect. 2020; 10 (3): e2000236. doi: 10.2106/JBJS.CC.20.00236
1) Suk KS, Kim KT, Lee SH, et al: Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixation. Int Orthop. 2006; 30: 290-294
6) Sagi HC, Beutler W, Carroll E, et al: Airway complications associated with surgery on the anterior cervical spine. Spine (Phila Pa 1976). 2002; 27: 949-953
8) Marquez-Lara A, Nandyala SV, Fineberg SJ, et al: Incidence, outcomes, and mortality of reintubation after anterior cervical fusion. Spine (Phila Pa 1976). 2014; 39: 134-139
11) Lee SH, Kim KT, Suk KS, et al: Effect of retropharyngeal steroid on prevertebral soft tissue swelling following anterior cervical discectomy and fusion: a prospective, randomized study. Spine (Phila Pa 1976). 2011; 36: 2286-2292
4) Yamagata T, Naito K, Yoshimura M, et al: Influence of prevertebral soft tissue swelling on dysphagia after anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage. J Craniovertebr Junction Spine. 2017; 8: 179-186
10) Andrew SA, Sidhu KS: Airway changes after anterior cervical discectomy and fusion. J Spinal Disord Tech. 2007; 20: 577-581
2) Song KJ, Choi BW, Kim HY, et al: Efficacy of postoperative radiograph for evaluating the prevertebral soft tissue swelling after anterior cervical discectomy and fusion. Clin Orthop Surg. 2012; 4: 77-82
7) Nagoshi N, Fehlings MG, Nakashima H, et al: Prevalence and Outcomes in Patients Undergoing Reintubation After Anterior Cervical Spine Surgery: Results From the AOSpine North America Multicenter Study on 8887 Patients. Global Spine J. 2017; 7: 96S-102S
5) Kim M, Choi I, Park JH, et al: Airway Management Protocol After Anterior Cervical Spine Surgery: Analysis of the Results of Risk Factors Associated With Airway Complication. Spine (Phila Pa 1976). 2017; 42: E1058-E1066
9) Kim SW, Jang C, Yang MH, et al: The natural course of prevertebral soft tissue swelling after anterior cervical spine surgery: how long will it last? Spine J. 2017; 17: 1297-1309
References_xml – reference: 7) Nagoshi N, Fehlings MG, Nakashima H, et al: Prevalence and Outcomes in Patients Undergoing Reintubation After Anterior Cervical Spine Surgery: Results From the AOSpine North America Multicenter Study on 8887 Patients. Global Spine J. 2017; 7: 96S-102S
– reference: 4) Yamagata T, Naito K, Yoshimura M, et al: Influence of prevertebral soft tissue swelling on dysphagia after anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage. J Craniovertebr Junction Spine. 2017; 8: 179-186
– reference: 5) Kim M, Choi I, Park JH, et al: Airway Management Protocol After Anterior Cervical Spine Surgery: Analysis of the Results of Risk Factors Associated With Airway Complication. Spine (Phila Pa 1976). 2017; 42: E1058-E1066
– reference: 2) Song KJ, Choi BW, Kim HY, et al: Efficacy of postoperative radiograph for evaluating the prevertebral soft tissue swelling after anterior cervical discectomy and fusion. Clin Orthop Surg. 2012; 4: 77-82
– reference: 11) Lee SH, Kim KT, Suk KS, et al: Effect of retropharyngeal steroid on prevertebral soft tissue swelling following anterior cervical discectomy and fusion: a prospective, randomized study. Spine (Phila Pa 1976). 2011; 36: 2286-2292
– reference: 1) Suk KS, Kim KT, Lee SH, et al: Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixation. Int Orthop. 2006; 30: 290-294
– reference: 3) Matsumoto T, Yamashita T, Okuda S, et al: A Detailed Clinical Course Leading to Hypoxic Ischemic Encephalopathy After Anterior Cervical Spine Surgery: A Case Report. JBJS Case Connect. 2020; 10 (3): e2000236. doi: 10.2106/JBJS.CC.20.00236
– reference: 8) Marquez-Lara A, Nandyala SV, Fineberg SJ, et al: Incidence, outcomes, and mortality of reintubation after anterior cervical fusion. Spine (Phila Pa 1976). 2014; 39: 134-139
– reference: 10) Andrew SA, Sidhu KS: Airway changes after anterior cervical discectomy and fusion. J Spinal Disord Tech. 2007; 20: 577-581
– reference: 6) Sagi HC, Beutler W, Carroll E, et al: Airway complications associated with surgery on the anterior cervical spine. Spine (Phila Pa 1976). 2002; 27: 949-953
– reference: 9) Kim SW, Jang C, Yang MH, et al: The natural course of prevertebral soft tissue swelling after anterior cervical spine surgery: how long will it last? Spine J. 2017; 17: 1297-1309
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SubjectTerms 椎体前面軟部組織腫脹
気管支鏡
頚椎前方手術
Title 頚椎前方手術後の椎体前面軟部組織腫脹は抜管前に予測できる
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