title: The Impact of Engorged Vein within Traumatic Posterior Neck Muscle Identified in Preoperative Computed Tomography Angiography to Estimated Blood Loss during Posterior Upper Cervical Spine Surgery.
abstract: OBJECTIVE
  Injuries of upper cervical spine are potentially fatal. Thus, appropriate diagnosis and treatment is essential. In our institute, preoperative computed tomography angiography (CTA) has been performed for evaluation of injuries of bony and vascular structure. The authors confirmed the engorged venous plexus within injured posterior neck muscle. We have this research to clarify the relationship between the engorged venous plexus and engorged vein.
  
  
  METHODS
  A retrospective review identified 23 adult patients who underwent 23 posterior cervical spine surgeries for treatment of upper cervical injury between 2013 and 2015. Preoperative CTA was used to identify of venous engorgement within posterior neck muscle. The male to female ratio was 18:5 and the mean age was 53.5 years (range, 25-78 years). Presence of venous engorgement and estimated blood loss (EBL) were analyzed retrospectively.
  
  
  RESULTS
  The EBL of group with venous engorgement was 454.55 mL. The EBL of group without venous engorgement was 291.67 mL. The EBL of group with venous engorgement was larger than control group in significant.
  
  
  CONCLUSIONS
  The presence of engorged venous plexus is important factor of intraoperative bleeding. Preoperative CTA for identifying of presence of engorged venous plexus and fine operative techniques is important to decrease of blood loss during posterior cervical spine surgery.
authors.affiliation: Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Mahn Jeong
authors.initials: MJ
authors.lastname: Ha
authors.affiliation: Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Kim
authors.affiliation: Department of Neuroradiology, Pusan National University Hospital, Busan, Korea.
authors.forename: Chae Wook
authors.initials: CW
authors.lastname: Huh
authors.affiliation: Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Cho
authors.affiliation: Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hyuk Jin
authors.initials: HJ
authors.lastname: Choi
keywords: Spinal injury; Surgical blood loss; Venous engorgement