PMID- 28110925
OWN - NLM
STAT- MEDLINE
DCOM- 20170529
LR  - 20220419
IS  - 1532-2653 (Electronic)
IS  - 0967-5868 (Linking)
VI  - 39
DP  - 2017 May
TI  - Airway adverse events following posterior occipito-cervical spinal fusion.
PG  - 124-129
LID - S0967-5868(16)30987-0 [pii]
LID - 10.1016/j.jocn.2016.12.036 [doi]
AB  - Management of the airway may be challenging in patients undergoing 
      occipito-cervical spine fusions (OCF). Changes in the occipito-cervical angle 
      (dOC2A) of fusion after surgery may result in acute airway obstruction, dyspnea 
      and/or dysphagia. Objectives of the study were to review the airway management of 
      patients during posterior OCF, determine the incidence, nature and risk factors 
      for postoperative airway adverse events (AEs), and to determine the relationship 
      between airway AEs and the change in dOC2A. In this retrospective cohort of 59 
      patients, following extubation in the operating room (OR), there were no 
      complications in 43 (73%) patients (Group 1). Sixteen (27%) patients (Group 2) 
      had airway complications; 4 requiring reintubation and 12 having delayed 
      extubation. The number of vertebral levels fused (>6), presence of difficult 
      intubation and duration of surgery (>5h) were significantly associated with AEs. 
      There was no significant difference in the dOC2A between the groups (-1.070+/-5.527 
      versus -4.375+/-10.788, p=0.127). Airway management in patients undergoing OCF 
      poses a challenge for the anesthesiology and surgical teams. The incidence of AEs 
      was 27%. The decision to extubate immediately after surgery needs to be 
      individualized. Factors such as difficult intubation, number of vertebral levels 
      fused and duration of surgery have to be considered. A significant correlation 
      between dOC2A and postoperative AEs could not be established. Risk factors for 
      postoperative AEs are multifactorial and prospective evaluation of these factors 
      is indicated.
CI  - Copyright (c) 2016 Elsevier Ltd. All rights reserved.
FAU - Sheshadri, Veena
AU  - Sheshadri V
AD  - Department of Anesthesia, Toronto Western Hospital, University of Toronto, 
      Canada. Electronic address: drveena_4u@yahoo.co.in.
FAU - Moga, Rebecca
AU  - Moga R
AD  - Department of Anesthesia, Toronto Western Hospital, University of Toronto, 
      Canada. Electronic address: Rebecca.Moga@uhn.ca.
FAU - Manninen, Pirjo
AU  - Manninen P
AD  - Department of Anesthesia, Toronto Western Hospital, University of Toronto, 
      Canada. Electronic address: Pirjo.Manninen@uhn.ca.
FAU - Goldstein, Christina L
AU  - Goldstein CL
AD  - Department of Orthopedic Surgery, Columbia, Missouri, United States. Electronic 
      address: goldsteincl@health.missouri.edu.
FAU - Rampersaud, Yoga Raja
AU  - Rampersaud YR
AD  - Department of Surgery, Divisions of Orthopedic and Neurosurgery, Toronto Western 
      Hospital, University of Toronto, Canada. Electronic address: 
      Raja.Rampersaud@uhn.ca.
FAU - Massicotte, Eric M
AU  - Massicotte EM
AD  - Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, 
      University of Toronto, Canada; Spine Program, McEwen Centre for Regenerative 
      Medicine, Toronto Western Hospital, University Health Network, Canada. Electronic 
      address: Eric.Massicotte@uhn.on.ca.
FAU - Fehlings, Michael G
AU  - Fehlings MG
AD  - Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, 
      University of Toronto, Canada; Spine Program, McEwen Centre for Regenerative 
      Medicine, Toronto Western Hospital, University Health Network, Canada. Electronic 
      address: Michael.Fehlings@uhn.ca.
FAU - Venkatraghavan, Lashmi
AU  - Venkatraghavan L
AD  - Department of Anesthesia, Toronto Western Hospital, University of Toronto, 
      Canada. Electronic address: Lashmi.Venkatraghavan@uhn.ca.
LA  - eng
PT  - Journal Article
DEP - 20170116
PL  - Scotland
TA  - J Clin Neurosci
JT  - Journal of clinical neuroscience : official journal of the Neurosurgical Society 
      of Australasia
JID - 9433352
SB  - IM
MH  - Adult
MH  - Aged
MH  - Airway Obstruction/*etiology/therapy
MH  - Cervical Vertebrae/*surgery
MH  - Deglutition Disorders/*etiology/therapy
MH  - Dyspnea/*etiology/therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Occipital Bone/*surgery
MH  - Postoperative Complications/*etiology/therapy
MH  - Retrospective Studies
MH  - Spinal Fusion/*adverse effects
OTO - NOTNLM
OT  - Airway adverse events
OT  - Airway management
OT  - Occipito-cervical angle
OT  - Occipito-cervical complex
OT  - Occipito-cervical fusion
EDAT- 2017/01/24 06:00
MHDA- 2017/05/30 06:00
CRDT- 2017/01/24 06:00
PHST- 2016/10/18 00:00 [received]
PHST- 2016/12/27 00:00 [accepted]
PHST- 2017/01/24 06:00 [pubmed]
PHST- 2017/05/30 06:00 [medline]
PHST- 2017/01/24 06:00 [entrez]
AID - S0967-5868(16)30987-0 [pii]
AID - 10.1016/j.jocn.2016.12.036 [doi]
PST - ppublish
SO  - J Clin Neurosci. 2017 May;39:124-129. doi: 10.1016/j.jocn.2016.12.036. Epub 2017 
      Jan 16.