RESEARCH ARTICLE


Airway Compromise Due to Wound Hematoma Following Anterior Cervical Spine Surgery



Mark A Palumbo*, 1, Jessica Pelow Aidlen1, Alan H Daniels1, Nikhil A Thakur1, Joseph Caiati2
1 Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
2 Department of Anesthesia, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA


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© Palumbo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Spine Surgery, Department of Orthopaedic Surgery, Alpert Medical School of Brown University, 2 Dudley Street, Suite 200, Providence, Rhode Island 02905, USA; Tel: 401-457-5195; Fax: 401-457-2141; E-mail: mpalmd@aol.com


Abstract

One of the most serious adverse events associated with anterior cervical spine surgery is wound hematoma resulting in airway compromise. The reported incidence of this postoperative complication has varied from 0.2% to 1.9%. Obstruction of the airway secondary to bleeding presents a challenging clinical scenario given the rapidity of onset, distorted anatomy of the upper respiratory tract, urgent need to act and potential for catastrophic consequences. This high-risk, life-threatening clinical scenario requires specialized knowledge and a well-designed treatment protocol to achieve a positive outcome. In this review, we report a case of airway compromise secondary to wound hematoma following anterior cervical discectomy and fusion, followed by a review of relevant literature, anatomy, etiologic factors and diagnostic considerations. We also propose guidelines for the prevention and management of postoperative airway obstruction due to wound hematoma.

Keywords: Anterior cervical spine surgery, adverse event, airway obstruction, hematoma.