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jim010@aol.com
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Keywords
Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure used to treat cervical spine pathology including radiculopathy and spinal cord compression. Although generally safe, postoperative complications can occur. One of the most feared complications is expanding neck hematoma, which may lead to rapid airway obstruction due to tracheal compression and soft tissue swelling. The reported incidence of postoperative hematoma after ACDF ranges from 0.2–1.9%, with a subset of patients requiring emergent airway intervention or surgical evacuation [1]. Patients with postoperative hematoma typically present with neck swelling, dysphagia, hoarseness, dyspnea, and inability to tolerate secretions, symptoms that may rapidly progress to airway obstruction [2]. Airway management in this setting is particularly challenging due to distorted anatomy, tracheal deviation, edema, and restricted neck mobility[3]. When intubation attempts fail and oxygenation cannot be maintained, emergent cricothyrotomy remains the definitive lifesaving intervention [4]. We present a case of acute airway compromise from an expanding postoperative hematoma after ACDF requiring emergent cricothyrotomy in the emergency department.
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure used to treat cervical spine pathology including radiculopathy and spinal cord compression. Although generally safe, postoperative complications can occur. One of the most feared complications is expanding neck hematoma, which may lead to rapid airway obstruction due to tracheal compression and soft tissue swelling. The reported incidence of postoperative hematoma after ACDF ranges from 0.2–1.9%, with a subset of patients requiring emergent airway intervention or surgical evacuation [1]. Patients with postoperative hematoma typically present with neck swelling, dysphagia, hoarseness, dyspnea, and inability to tolerate secretions, symptoms that may rapidly progress to airway obstruction [2]. Airway management in this setting is particularly challenging due to distorted anatomy, tracheal deviation, edema, and restricted neck mobility[3]. When intubation attempts fail and oxygenation cannot be maintained, emergent cricothyrotomy remains the definitive lifesaving intervention [4]. We present a case of acute airway compromise from an expanding postoperative hematoma after ACDF requiring emergent cricothyrotomy in the emergency department.
Disciplines
Medicine and Health Sciences | Surgery
Included in
A Neck Too Tight: Emergent Cricothyrotomy for Airway Collapse from Expanding Post Anterior Cervical Discectomy and Fusion (ACDF) Hematoma
Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure used to treat cervical spine pathology including radiculopathy and spinal cord compression. Although generally safe, postoperative complications can occur. One of the most feared complications is expanding neck hematoma, which may lead to rapid airway obstruction due to tracheal compression and soft tissue swelling. The reported incidence of postoperative hematoma after ACDF ranges from 0.2–1.9%, with a subset of patients requiring emergent airway intervention or surgical evacuation [1]. Patients with postoperative hematoma typically present with neck swelling, dysphagia, hoarseness, dyspnea, and inability to tolerate secretions, symptoms that may rapidly progress to airway obstruction [2]. Airway management in this setting is particularly challenging due to distorted anatomy, tracheal deviation, edema, and restricted neck mobility[3]. When intubation attempts fail and oxygenation cannot be maintained, emergent cricothyrotomy remains the definitive lifesaving intervention [4]. We present a case of acute airway compromise from an expanding postoperative hematoma after ACDF requiring emergent cricothyrotomy in the emergency department.