Analysis of early complications in anterior cervical spine surgery / 中华骨科杂志

ABSTRACT

Objective To analyze the reasons of early complications in anterior cervical spine surgery and its management. Methods Between Jan 1992 and Dec. 2003, 412 patients underwent anterior cervical surgery. There were 308 males and 104 females with an average age of 45.6 years (18-76). The di-agnosis of these patients included 258 of cervical spondylosis, 138 of cervical injury, 8 of cervical spinal tu-mor and 8 of tuberculosis of cervical spine. The medical history was from 4 hours to 20 years with an aver-age duration of 548 days. Among 412 patients, there were 58 cases (14.1%) with complete paraplegia, 192 cases (46.6%) with incomplete paraplegia and 162 cases without neurological deficits. Anesthesia used in this group of patients were local in 35, cervical plexus block in 52, local associated with cervical plexus block in 6, general in 318 and general associated with cervical plexus block in 1. Three surgical procedures were performed 1) anterior decompression and interbody fusion with autogenous iliac crest in 33 cases; 2) anterior decompression and interbody fusion with threaded fusion cage in 32 cases; 3) anterior decompres-sion, interbody fusion with autogenous iliac crest and plate fixation in 347 cases. Results Fifty-one early complications occurred in 42 patients and the incidence was 12.37%. 28 patients (6.8%) had complications directly related to the procedure which included superior laryngeal nerve injury in 5, recurrent laryngeal nerve injury in 4, migration of bone graft in 2, infection or haematoma in 4, deterioration of neurological function in 5,nerve root injury in 2, loosening of screw or plate fixation in 2 and esophageal fistula in 1. 23 cases (5.08%) had early complications indirectly related to the procedure. Conclusion In order to reduce the incidence of early complications in anterior cervical spine surgery, make familiarization with anatomy, improvement of surgical skill as well as appropriate perioperative management are essential in anterior cer-vical spine surgery.