Intraoperative Complications During Surgery on the Posterior Cervical Spine (original) (raw)
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Complications of Anterior and Posterior Cervical Spine Surgery
Asian Spine Journal, 2016
Cervical spine surgery performed for the correct indications yields good results. However, surgeons need to be mindful of the many possible pitfalls. Complications may occur starting from the anaesthestic procedure and patient positioning to dura exposure and instrumentation. This review examines specific complications related to anterior and posterior cervical spine surgery, discusses their causes and considers methods to prevent or treat them. In general, avoiding complications is best achieved with meticulous preoperative analysis of the pathology, good patient selection for a specific procedure and careful execution of the surgery. Cervical spine surgery is usually effective in treating most pathologies and only a reasonable complication rate exists.
Perioperative and Approach-Related Complications Associated with Anterior Cervical Surgery
Seminars in Spine Surgery, 2009
The anterior approach to the cervical spine follows a well-defined fascial plane to the vertebral bodies and discs and allows for good decompression of the spinal cord and nerve roots. Interbody fusion and anterior instrumentation can be carried out with little added morbidity. Patients can anticipate good outcomes, and the risk of complications is small in the hands of an experienced surgeon. This article reviews the published data on complications of the anterior approach to the cervical spine, focusing on etiology, diagnosis, and management of these complications. Raising the surgeons' awareness on complications that are possible during the procedure is essential in minimizing the incidence of adverse events, and allows for early detection and appropriate management of complications when they do occur. Semin Spine Surg 21:148-155
A Method for Intraoperative Repositioning of the Cervical Spine During Posterior Cervical Surgery
Orthopedics, 2011
Positioning of the head during posterior cervical decompression and fusion requires invasive techniques (eg, pins placed through the skull) and manual repositioning intraoperatively. This article describes a new technique with a noninvasive device for such positioning. From February 2005 until June 2010 at our institution, 94 patients underwent posterior cervical decompression and fusion with instrumentation. All were positioned prone, and their heads were positioned via our technique and customized device. There were no intraoperative complications secondary to this positioning. The device is easy to use, avoids complications associated with invasive devices, and obviates intraoperative repositioning during posterior approaches.
Global Spine Journal, 2016
Study Design Retrospective review of prospectively gathered data. Objective To report the rate and impact of perioperative complications in cervical spine surgery. To our knowledge, no prior study of the cervical spine has analyzed a large prospectively gathered data set for adverse events, based on surgical subgroup. Methods The ProSTOS database features prospectively documented perioperative adverse events for 1,269 patients who had cervical spine surgery at multiple centers in North America between 2008 and 2011. We subgrouped patients by approach, whether surgery was a primary or revision operation, and by the number of levels involved. Multivariate analysis with stepwise logistic regression was used to relate complication rates to gender, age, smoking status, body mass index, approach, revision status, and number of levels involved. Follow-up was 41%. Results Adverse events occurred significantly more frequently in posterior and combined procedures than in anterior procedures. ...
Anterior cervical spine surgical complications: Safety comparison between teacher and student
Surgical Neurology International, 2021
Background: Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience. Methods: We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years’ experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson’s Chi-square and Fisher’s test). Results: The to...
Complications of anterior cervical spine surgery
PubMed, 2003
The anterior approach to the cervical spine is often used to treat many afflictions of the cervical spine. Although many complications can occur, the incidence of these complications is relatively low, especially when the physician has a thorough knowledge of spine anatomy and uses meticulous surgical technique.
Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study
Global spine journal, 2017
A retrospective multicenter study. Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery. Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death. A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There ...
Acta Orthopaedica Et Traumatologica Hellenica, 2021
Anterior and posterior surgical approaches are used for immobilization of the unstable features of the cervical spine. The choice for optimal approach is still under discussion. Each procedure has advantages and disadvantages and the surgeon must be aware to make the right decision to assure patient's safety. Intraoperative evaluation of reduction is essential to ensure satisfactory postoperative outcomes. However, immediate postoperative neurologic improvement is rare for patients with preoperative neurologic deficit and thus postoperative rehabilitation for improvement of motor and neurologic dysfunctions is imperative. Literature data report minor or severe intraoperative and postoperative complications for cervical spine surgery. The purpose of this mini review is to provide literature data on cervical spinal cord injuries and assess optimal surgical treatment based on cervical injury level. Moreover, the rate of postoperative complications and recovery time will be discussed.
Outpatient Surgery in the Cervical Spine: Is It Safe?
Evidence-Based Spine-Care Journal, 2014
Study Design Systematic review. Study Rationale As the length of stay after cervical spine surgery has decreased substantially, the feasibility and safety of outpatient cervical spine surgery come into question. Although minimal length of stay is a targeted metric for quality and costs for medical centers, the safety of outpatient cervical spine surgery has not been clearly defined. Objective The objective of this article is to evaluate the safety of inpatient versus outpatient surgery in the cervical spine for adult patients with symptomatic or asymptomatic degenerative disc disease. Methods A systematic review of the literature was undertaken for articles published through February 19, 2014. Electronic databases and the bibliographies of key articles were searched to identify comparative studies evaluating the safety of inpatient versus outpatient surgery in the cervical spine. Spinal cord stimulation, spinal injections, and diagnostic procedures were excluded. Two independent reviewers assessed the strength of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, and disagreements were resolved by consensus. Results Five studies that met the inclusion criteria were identified. One study reported low risk of hematoma (0% of outpatients and 1.6% of inpatients). Two studies reported on mortality and both reported no deaths in either group following surgery. Dysphagia risks ranged from 0 to 10% of outpatients and 1.6 to 5% of inpatients, and infection risks ranged from 0 to 1% of outpatients and 2 to 2.8% of inpatients. One study reported that no (0) outpatients were readmitted to the hospital due to a complication, compared with four inpatients (7%). The overall strength of evidence was insufficient for all safety outcomes examined. Conclusion Though the studies in our systematic review did not suggest an increased risk of complication with outpatient cervical spine surgery, the strength of evidence to make a recommendation was insufficient. Further study is needed to more clearly define the role of outpatient cervical spine surgery.