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Ectopic gas in the fibular graft after anterior cervical corpectomy and fusion

Background Ectopic gas in the graft is occasionally encountered upon follow-up computed tomography (CT) after anterior cervical corpectomy and fusion (ACCF). However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graf...

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Published in:BMC musculoskeletal disorders 2021-11, Vol.22 (1), p.1-995, Article 995
Main Authors: Nozawa, Satoshi, Kato, Hiroki, Kawaguchi, Masaya, Nozawa, Asae, Yamada, Kazunari, Iwai, Chizuo, Fushimi, Kazunari, Miyamoto, Kei, Hosoe, Hideo, Shimizu, Katsuji, Matsuo, Masayuki, Akiyama, Haruhiko
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creator Nozawa, Satoshi
Kato, Hiroki
Kawaguchi, Masaya
Nozawa, Asae
Yamada, Kazunari
Iwai, Chizuo
Fushimi, Kazunari
Miyamoto, Kei
Hosoe, Hideo
Shimizu, Katsuji
Matsuo, Masayuki
Akiyama, Haruhiko
description Background Ectopic gas in the graft is occasionally encountered upon follow-up computed tomography (CT) after anterior cervical corpectomy and fusion (ACCF). However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graft has not yet been established, to the best of our knowledge, no previous studies have described ectopic gas in the graft after ACCF. This study evaluated ectopic gas in the fibular graft upon follow-up CT after ACCF. Methods We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 3 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Results Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late-onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Conclusion Ectopic gas in the fibular graft was observed at both early and late-onset after ACCF; late-onset gas remained significantly. The remaining gas was strongly associated with pseudoarthrosis; therefore, pseudoarthrosis should be considered when ectopic gas in the graft is observed on CT images. Keywords: Ectopic gas, Anterior cervical corpectomy and fusion, Pseudoarthrosis
doi_str_mv 10.1186/s12891-021-04874-6
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However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graft has not yet been established, to the best of our knowledge, no previous studies have described ectopic gas in the graft after ACCF. This study evaluated ectopic gas in the fibular graft upon follow-up CT after ACCF. Methods We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 3 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Results Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late-onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Conclusion Ectopic gas in the fibular graft was observed at both early and late-onset after ACCF; late-onset gas remained significantly. The remaining gas was strongly associated with pseudoarthrosis; therefore, pseudoarthrosis should be considered when ectopic gas in the graft is observed on CT images. Keywords: Ectopic gas, Anterior cervical corpectomy and fusion, Pseudoarthrosis</description><identifier>ISSN: 1471-2474</identifier><identifier>EISSN: 1471-2474</identifier><identifier>DOI: 10.1186/s12891-021-04874-6</identifier><identifier>PMID: 34844589</identifier><language>eng</language><publisher>London: BioMed Central Ltd</publisher><subject>Age ; Anterior cervical corpectomy and fusion ; Blood gases ; Bone grafts ; Complications ; Complications and side effects ; Computed tomography ; Ectopic gas ; Health aspects ; Infections ; Inflammation ; Nitrogen ; Pain ; Patients ; Physiological aspects ; Pseudoarthrosis ; Skin &amp; tissue grafts ; Spine ; Statistical analysis ; Surgery ; Tomography ; Transplantation of organs, tissues, etc</subject><ispartof>BMC musculoskeletal disorders, 2021-11, Vol.22 (1), p.1-995, Article 995</ispartof><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c491t-36a8c4d543b9c921b505cbf0284a953db49cea69d3193bd2bbc00ca12bbc45403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630856/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2611249001?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53769,53771</link.rule.ids></links><search><creatorcontrib>Nozawa, Satoshi</creatorcontrib><creatorcontrib>Kato, Hiroki</creatorcontrib><creatorcontrib>Kawaguchi, Masaya</creatorcontrib><creatorcontrib>Nozawa, Asae</creatorcontrib><creatorcontrib>Yamada, Kazunari</creatorcontrib><creatorcontrib>Iwai, Chizuo</creatorcontrib><creatorcontrib>Fushimi, Kazunari</creatorcontrib><creatorcontrib>Miyamoto, Kei</creatorcontrib><creatorcontrib>Hosoe, Hideo</creatorcontrib><creatorcontrib>Shimizu, Katsuji</creatorcontrib><creatorcontrib>Matsuo, Masayuki</creatorcontrib><creatorcontrib>Akiyama, Haruhiko</creatorcontrib><title>Ectopic gas in the fibular graft after anterior cervical corpectomy and fusion</title><title>BMC musculoskeletal disorders</title><description>Background Ectopic gas in the graft is occasionally encountered upon follow-up computed tomography (CT) after anterior cervical corpectomy and fusion (ACCF). However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graft has not yet been established, to the best of our knowledge, no previous studies have described ectopic gas in the graft after ACCF. This study evaluated ectopic gas in the fibular graft upon follow-up CT after ACCF. Methods We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 3 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Results Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late-onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Conclusion Ectopic gas in the fibular graft was observed at both early and late-onset after ACCF; late-onset gas remained significantly. The remaining gas was strongly associated with pseudoarthrosis; therefore, pseudoarthrosis should be considered when ectopic gas in the graft is observed on CT images. 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However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graft has not yet been established, to the best of our knowledge, no previous studies have described ectopic gas in the graft after ACCF. This study evaluated ectopic gas in the fibular graft upon follow-up CT after ACCF. Methods We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 3 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Results Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late-onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Conclusion Ectopic gas in the fibular graft was observed at both early and late-onset after ACCF; late-onset gas remained significantly. The remaining gas was strongly associated with pseudoarthrosis; therefore, pseudoarthrosis should be considered when ectopic gas in the graft is observed on CT images. Keywords: Ectopic gas, Anterior cervical corpectomy and fusion, Pseudoarthrosis</abstract><cop>London</cop><pub>BioMed Central Ltd</pub><pmid>34844589</pmid><doi>10.1186/s12891-021-04874-6</doi><oa>free_for_read</oa></addata></record>
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subjects Age
Anterior cervical corpectomy and fusion
Blood gases
Bone grafts
Complications
Complications and side effects
Computed tomography
Ectopic gas
Health aspects
Infections
Inflammation
Nitrogen
Pain
Patients
Physiological aspects
Pseudoarthrosis
Skin & tissue grafts
Spine
Statistical analysis
Surgery
Tomography
Transplantation of organs, tissues, etc
title Ectopic gas in the fibular graft after anterior cervical corpectomy and fusion
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