Gelfoam-induced Swallowing Difficulty after Anterior Cervical Spine Surgery

다국어 초록 (Multilingual Abstract)

Symptomatic diffuse idiopathic skeletal hyperostosis (DISH) is not common. Gelfoam is one of the most commonly used topical hemostatic agents. But, in the partially moistened state, air retained in its pores may result in excessive expansion on contact with liquid. The onset of swallowing difficulty after anterior cervical spine surgery due to appling gelfoam is a rare complication. A 77-year-old man with swallowing difficulty was admitted to our hospital and we diagnosed him as DISH confirmed by radiological study. After removing the DISH, patient’s symptom was relieved gradually. However, on postoperative day (POD) 7, the symptom recurred but lesser than the preoperative state. We confirmed no hematoma and esophageal perforation on the operation site. We observed him closely and controlled the diet. Three months later, he had no symptom of swallowing difficulty, and was able to be back on a regular diet, including solid foods. We present a complication case of swallowing difficulty occurring by gelfoam application.

참고문헌 (Reference)

1 송봉규, "경추부 전종인대골화증에 의한 연하곤란증" 대한척추신경외과학회 6 (6): 86-89, 2009

2 Carlson ML, "Surgical management of dysphagia and airway obstruction in patients with prominent ventral cervical osteophytes" 26 : 34-40, 2011

3 Aydin E, "Six cases of Forestier syndrome, a rare cause of dysphagia" 21 : 259-263, 2006

4 Miyamoto K, "Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis" 18 : 1652-1658, 2009

5 Winslow CP, "Otolaryngologic complications of the anterior approach to the cervical spine" 20 : 16-27, 1999

6 Friedman J, "Lumbar cauda eqina syndrome associated with the use of gelfoam" 26 (26): 485-487, 2001

7 Epstein NE, "Increased postoperative cervical myelopathy and cord compression resulting from the use of gelfoam" 9 : 19-21, 2009

8 Alaxander DH, "Gelfoam-induced acute quadriparesis after cervical decompression and fusion" 20 (20): 970-971, 1995

9 Buchowski JM, "Epidural spinal cord compression with neurologic deficit associated with intrapedicular application of hemostatic gelatin matrix during pedicle screw insertion" 34 (34): 473-477, 2009

10 De Jesus-Monge WE, "Dysphagia and lung aspiration secondary to anterior cervical osteophytes: A case report and review of the literature" 18 : 137-140, 2008

11 Krishnarasa B, "Diffuse idiopathic skeletal hyperostosis (DISH) - A rare etiology of dysphagia" 4 : 71-75, 2011

12 Fountas KN, "Anterior cervical discectomy and fusion associated complications" 32 (32): 2310-2317, 2007