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The Journal of Bone and Joint Surgery, Vol 73, Issue 4 544-551, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Upper-airway obstruction after multilevel cervical corpectomy for myelopathy

SE Emery, MD Smith and HH Bohlman
Department of Orthopaedics, University Hospitals, Cleveland, Ohio.

We reviewed the cases of seven patients who had had obstruction of the upper airway immediately after an anterior procedure on the cervical spine and had required reintubation. All patients had had moderate or severe myelopathy preoperatively (average, 3.6 on the Nurick scale), and all had had a multilevel anterior cervical corpectomy for decompression followed by arthrodesis. The early compromise of the upper airway was believed to be due to edema rather than to the formation of a hematoma. Five patients had no sequelae, but two died of complications related to the obstruction. Risk factors common to these patients included moderate or severe myelopathy and multilevel corpectomy. Six patients had a history of heavy smoking and one, of asthma. We believe that extra caution should be used in the postoperative management of the airways when multilevel corpectomy is performed in patients who have these pre-existing conditions.
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