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Advances in Orthopedics
Volume 2011, Article ID 791923, 5 pages
http://dx.doi.org/10.4061/2011/791923
Case Report

Prolonged Airway Obstruction after Posterior Occipitocervical Fusion: A Case Report and Literature Review

1Department of Orthopaedic Surgery, Izumi Municipal Hospital, 4-10-10 Fuchu Izumi City, Osaka 594-0071, Japan
2Department of Neurosurgery, Izumi Municipal Hospital, 4-10-10 Fuchu Izumi City, Osaka 594-0071, Japan
3Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-5-7 Asahi Abeno, Osaka 545-0051, Japan

Received 19 January 2011; Accepted 9 May 2011

Academic Editor: John P. Kostuik

Copyright © 2011 Masahiro Morita et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this paper was to inform the reader that prolonged upper airway obstruction after posterior cervical spine surgery is a possible complication for patients with metastatic tumor of upper cervical spine. A 49-year-old man presented severe neck pain during posture changes due to metastatic spinal tumor of C2. Occipitocervical fusion following removal of the posterior arch of C1 and laminectomy of C2 via the single posterior approach was performed 2 weeks after radiation therapy. After the surgery, life-threatening airway obstruction due to pharyngeal oedema occurred immediately after extubation that required emergency tracheostomy. The airway obstruction did not improve well during the patient's postoperative course. Once pharyngeal oedema occurs in patients with metastatic tumor of upper cervical spine who undergo posterior cervical spine surgery following radiation therapy to the neck, the pharyngeal oedema may be constant for a long period of time.