Anterior Cervical Idiopathic Hyperostosis and Dysphagia: The Impact of Surgical Management-Study of a Series of 11 Cases.

Autor: Damade C; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Masse R; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Ghailane S; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Petit M; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Castelain JE; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Gille O; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Mazas S; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Bouyer B; L'Institut de la Colonne Vertébrale, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Kieser DC; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago School of Medicine, Christchurch, New Zealand. Electronic address: kieserdavid@gmail.com.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Jun; Vol. 138, pp. e305-e310. Date of Electronic Publication: 2020 Feb 25.
DOI: 10.1016/j.wneu.2020.02.097
Abstrakt: Objective: To assess the efficacy and safety of surgery for dysphagia in anterior cervical idiopathic hyperostosis.
Methods: This retrospective study included 11 consecutive patients presenting with dysphagia and anterior cervical idiopathic hyperostosis. Computed tomography scans and dynamic swallowing fluoroscopies were performed. The site of compression and the size and position of osteophytes were measured. The clinical outcomes and complications were recorded.
Results: Two patients with anterior esophageal compression were found to have dysphagia caused by lower esophageal sphincter dysfunction. In the remaining 9 patients, the level of maximal compression was between C3 and C5 with the size of the osteophytes ranging from 8 to 17 mm. Intubation was challenging in 7 patients. Postoperative transient worsening of dysphagia was encountered in 3 patients. Two patients experienced severe complications including aphagia and respiratory compromise. Within 2 months of the operation, all patients reported satisfactory improvement of symptoms and a considerable gain in quality of life. No recurrence had occurred at final follow-up.
Conclusions: Anterior cervical hyperostosis causing dysphagia typically affects older men and results from compression between C3 and C5 from osteophytes of variable sizes. Operative intervention can provide long-lasting resolution of symptoms but is complicated by difficulty in endotracheal intubation, postoperative dysphagia, and rarely respiratory compromise. A systematic preoperative ear, nose, and throat consultation is recommended to reduce these complications.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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