title: Effect of Preoperative Tracheal Stretch Exercise on Anterior Cervical Spine Surgery: A Retrospective Study.
abstract: METHODS
  We designed a retrospective study on preoperative tracheal stretch exercise (TSE) before anterior cervical spine surgery. The changes in vital signs before and during the surgery and the postoperative clinical outcome were recorded and compared with none treated patients.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether the preoperative TSE is beneficial to the anterior cervical spine surgery and clinical outcome.
  
  
  BACKGROUND
  Anterior approach to the cervical spine surgery requires prolonged retraction of the trachea and esophagus. Although the surgery can be managed to complete, related potential complications may occur.
  
  
  METHODS
  This is a retrospective study on 128 patients scheduled for anterior cervical spine surgery. Patients in the stretched group received preoperative TSE for 3 consecutive days before surgery, whereas the control group did not. During the preoperative exercise and the surgery, the changes in the vital signs were recorded and compared with the control group. The visual analogue scale, neck disability index (NDI), and the Clinical Symptom Score of the Japanese Orthopaedic Association (JOA) were also compared at different follow-up intervals, including 1, 3, and 6 months postoperation.
  
  
  RESULTS
  The changes in blood pressure, heart rate, and respiratory and swallowing rates during the first exercise are significantly greater than those during the last exercise (P<0.05). During the surgery, changes in the vital signs in the exercise patients are also significantly smaller than those in control patients (P<0.05), excluding the blood oxygen saturation. The significant differences were also observed with the postoperative NDI and JOA scores between the exercise and control group at 6 months (P<0.05).
  
  
  CONCLUSIONS
  Proper and systematic preoperative TSE has great significance for the success of anterior cervical spine surgery.
authors.affiliation: Departments of *Orthopaedic Surgery †Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi ‡Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, Beijing, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.forename: Xiong
authors.initials: X
authors.lastname: Zhao
authors.forename: Zixiang
authors.initials: Z
authors.lastname: Wu
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Shi
authors.forename: Geng
authors.initials: G
authors.lastname: Cui
authors.forename: Wei
authors.initials: W
authors.lastname: Lei
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000601:surgery*; D003710:Demography; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011300:Preoperative Care; D012189:Retrospective Studies; D014132:Trachea / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D055986:Vital Signs