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Forum Name: Surgery Topics

Question: Worsened OSA after Anterior Cervicle Discectomy


 george50 - Mon Nov 03, 2008 9:03 am

I had a three level Anterior Cervical Discectomy, with the installation of a cage, in April, 2006. I informed my surgeon and anesthisiologist that I suffered from OSA prior to surgery and was assured that there should be no problems. I do not recall waking up at any point after the surgery. It was over a month later that I first began to realize where I was, and that "something"had happened. I was told that I had started having difficulty breathing soon after I was moved to ICU from recovery and had to be re-intubated. I was kept in a medically induced coma for about 4 weeks because I could not be weaned from the ventalator. I contracted MARSA and double Pnumonia while I was in the coma. As soon as the opening for the trach healed I went back to using my CPAP. My question is, It seems I am having more trouble these days with my apnea, could the surgery have worsened my OSA?
 Dr. Safaa Mahmoud - Fri Nov 14, 2008 11:08 am

User avatar Hello,

Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. During sleeping our muscles relax including the throat and the airway muscles but if they collapse they can obstruct breathing during sleep.
This can affect all of us temporary during respiratory tract infections but in those who suffer from recurrent attacks that deprive them from good sleeping are said to have sleep apnea SA.

These individuals should be very cautious when have to go for surgery or receive medications. Many drugs and agents used for anesthesia remain in our body in a considerable level from hours to days after their use, thus ASO individuals can be exposed to life-threatening irregularities in breathing.
And this is what is exactly happened to you. Even analgesics and sedatives should be minimized if cannot be avoided.

Whether your symptoms are now more frequent as a complication from the operation or not, is really a difficult question to answer. Since many OSA individuals have progressive course without being exposed to your experience.

However being exposed to a serious chest infection and postoperative manipulation may add some weakness to this part of the body and make you at risk of recurrent infections which consequently means more OSA attacks.

In any case you better follow up with your doctor for proper evaluation and management.
Please keep us updated.
Best regards.
 george50 - Tue Jan 06, 2009 11:26 am

Doctor Mahmoud.

I was diagnosed with sleep apnea 8 years ago. I began using a CPAP at that time. I had no problems with the apnea until mid-June, following the April '06 surgery. I did not even have to use the CPAP until the trache incision healed. But soon after the trache incision healed I began having difficulty sleeping again. The apnea has continued to worsen and my ENT thinks it could be due to the hardware in my throat; damage to my respiratory system from the infections; the drugs to maintain the induced coma while intubated; my partially paralized left vocal chord and/or the mild dysphagia that continues to linger on, any one, or all these things. I once again have apnea problems almost as bad as before the CPAP and I am still using it every night. In addition, I now have major problems with "mouth leak".
I have a new sleep study scheduled in a couple of weeks and I am waiting for the results and reccomendations from that.

Thank You for your reply
George,50

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