Kumar Nishant, Patel Ravish Shammi, Thong Mark Kim Thye, Kumar Naresh
Department of Orthopedic Surgery, National University Hospital, Singapore.
Department of Otorhinolaryngology, National University Hospital, Singapore.
BMJ Case Rep. 2018 Jun 20;2018:bcr-2017-223322. doi: 10.1136/bcr-2017-223322.
Ossification of the anterior longitudinal ligament (OALL) in cervical spine is known to cause dysphagia. However, dyspnoea and obstructive sleep apnoea (OSA) due to OALL is a rare entity. A 50-year-old man presented to our clinic 2 years after anterior cervical discectomy and fusion (ACDF) with complaints of dysphagia, dyspnoea and difficulty in sleeping supine. The clinico-neurological examination of patient was normal without any long tract signs. The diagnosis of OALL was made on plain lateral radiographs. Ultrasonic bone cutter was used to convert sessile osteophyte mass into a pedunculated mass. It was then disconnected from the anterior aspect of vertebral bodies with a chisel. The patient showed immediate relief from dysphagia and OSA. Dyspnoea improved over a week and the postoperative change in voice responded well to speech therapy. To the best of our knowledge, this is the first report of dyspnoea due to OALL after ACDF.
已知颈椎前纵韧带骨化(OALL)会导致吞咽困难。然而,由OALL引起的呼吸困难和阻塞性睡眠呼吸暂停(OSA)是一种罕见的情况。一名50岁男性在接受颈椎前路椎间盘切除融合术(ACDF)两年后到我们诊所就诊,主诉吞咽困难、呼吸困难和仰卧位睡眠困难。患者的临床神经学检查正常,没有任何长束征。通过普通侧位X线片做出了OALL的诊断。使用超声骨刀将无蒂骨赘块转化为有蒂块。然后用凿子将其从椎体前方分离。患者的吞咽困难和OSA立即得到缓解。呼吸困难在一周内有所改善,术后声音变化对言语治疗反应良好。据我们所知,这是ACDF术后因OALL导致呼吸困难的首例报告。