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The report describes a 27-year-old woman undergoing anterior decompression and total disk arthroplasty for cervical disc disease, where pneumothorax concerns required close postoperative monitoring. The discussion links risk to patient positioning, positive-pressure ventilation with positive end-expiratory pressure/CPAP, and pressure differentials around the tracheoesophageal complex. Clinicians should maintain vigilance and not dismiss symptoms solely due to initially negative scans.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/spontaneous-contralateral-pneumothorax-a-rare-but-potential-complication-of-anterior-cervical-total-disk-arthroplasty-a-case-report/450914/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/spontaneous-contralateral-pneumothorax-a-rare-but-potential-complication-of-anterior-cervical-total-disk-arthroplasty-a-case-report/450914.png","ImageObject",300,407,{"name":92,"@type":93},"นรินทร์","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"What factors are discussed as potential contributors during anterior cervical surgery?","Question",{"text":112,"@type":113},"The authors discuss the role of patient positioning, positive-pressure ventilation with positive end-expiratory pressure/CPAP, and potential pressure differentials separating the tracheoesophageal complex from the pre-vertebral potential space.","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},450914,1790791666,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":131,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":67,"update_tm":135,"read_time":136,"preview_page_count":4},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","Spontaneous contralateral pneumothorax: a rare but potential complication of anterior cervical total disk arthroplasty—a case report  \nSamantha Hill1^, Miguel Schmitz2^  \n1Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; 2Alpine Orthopaedic and Spine, Spokane, WA, USA Contributions: (I) Conception and design: Both authors; (II) Administrative support: M Schmitz; (III) Provision of study materials or patients: M Schmitz; (IV) Collection and assembly of data: S Hill; (V) Data analysis and interpretation: S Hill; (VI) Manuscript writing: Both authors; (VII) Final approval of manuscript: Both authors.  \nCorrespondence to: Samantha Hill, BS. Elson S. Floyd College of Medicine, Washington State University, 412 E Spokane Falls Blvd, Spokane, WA  \n99202, USA. Email: [Samantha.m.hill@wsu.edu](Samantha.m.hill@wsu.edu).  \nBackground: Anterior cervical discectomy and fusion (ACDF) surgery is a treatment for cervical disk herniation, a condition that may contribute to compression upon the spinal cord or the exiting nerve roots. The primary goals of this surgery are to decompress the neurological structures while stabilizing segments that are either unstable intrinsically or unstable by way of decompression. More recently, total disk arthroplasty (TDA) and anterior decompression has been introduced as an alternative to ACDF.  \nPneumothorax is caused by air filling the pleural cavity between the parietal pleura and the lung, causing the lung to collapse from the loss of negative pressure in that space, impairing lung function. The development of pneumothorax is a rare event during anterior approaches to the cervical spine, but the authors are not  \naware of the development during surgery of a pneumothorax contralateral to the side of approach.  \nCase Description: A 27-year-old female patient with cervical disc disease associated with C5–C6 and C6–C7. The patient has a history of smoking, an incomplete right bundle branch block, postural orthostatic tachycardia syndrome, premature ventricular contraction, and fibromyalgia, presented to the operating room for anterior decompression and TDA of C5–C6 and C6–C7 for cervical disk disease. There was no history of  \nsoft tissue disease.  \nConclusions: During anterior cervical spine surgery, contralateral pneumothorax can occur. This may happen due to the 30-degree positioning, positive pressure ventilation with positive end-expiratory pressure/ continuous positive airway pressure, and potential pressure differential separating the tracheoesophageal complex from the pre-vertebral potential space. There are no current preventative measures for pneumothorax during anterior cervical spine surgery with standard techniques, but it is important not to dismiss the condition based solely on initial negative imaging results. Spontaneous contralateral pneumothorax is not commonly recognized as a complication of anterior cervical spine surgery; however,  \nphysicians should be aware of the possibility of its occurrence.  \nKeywords: Anterior cervical discectomy and fusion (ACDF); total disk arthroplasty (TDA); spontaneous  \npneumothorax; case report  \nSubmitted Feb 12, 2025. Accepted for publication Jun 05, 2025. Published online Dec 17, 2025.  \ndoi: 10.21037/jss-25-30  \nView this article at: [https://dx.doi.org/10.21037/jss-25-30](https://dx.doi.org/10.21037/jss-25-30)  \n^ ORCID: Samantha Hill, 0009-0007-1406-9876; Miguel Schmitz, 0000-0002-7350-2605.  \n© AME Publishing Company. J Spine Surg 2025;11(4):1111-1117 | [https://dx.doi.org/10.21037/jss-25-30](https://dx.doi.org/10.21037/jss-25-30)  \n1112 Hill and Schmitz. Spontaneous pneumothorax post-cervical disk arthroplasty  \nIntroduction  \nUnder endotracheal intubation and general anesthesia, anterior cervical discectomy and fusion (ACDF) involves removing the vertebral disc from the affected intervertebral space by accessing the anterior aspect of the cervical spine, as described by Robertson [1978] and O’Neill [2016] via an int","cbCaioF6XC2Phi1k","https://ap.wps.com/l/cbCaioF6XC2Phi1k","pdf",1328114,"English","# Background\n# Case Description\n# Conclusions\n# Introduction\n## Highlight box","[{\"question\":\"What factors are discussed as potential contributors during anterior cervical surgery?\",\"answer\":\"The authors discuss the role of patient positioning, positive-pressure ventilation with positive end-expiratory pressure/CPAP, and potential pressure differentials separating the tracheoesophageal complex from the pre-vertebral potential space.\"}]","Spontaneous contralateral pneumothorax - a rare but potential complication of anterior cervical total disk arthroplasty - a case report | PDF",1790734074,18]