open access

Vol 48, No 6 (2014)
Original research articles
Submitted: 2014-02-26
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Comparison of perioperative complications following staged versus one-day anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction

Kris Siemionow, Marcin Tyrakowski, Kushal Patel, Sergey Neckrysh
DOI: 10.1016/j.pjnns.2014.10.001
·
Neurol Neurochir Pol 2014;48(6):403-409.

open access

Vol 48, No 6 (2014)
Original research articles
Submitted: 2014-02-26

Abstract

Introduction

Multilevel cervical pathology may be treated via combined anterior cervical decompression and fusion (ACDF) followed by posterior spinal instrumented fusion (PSIF) crossing the cervico-thoracic junction.

The purpose of the study was to compare perioperative complication rates following staged versus same day ACDF combined with PSIF crossing the cervico-thoracic junction.

Material and methods

A retrospective review of consecutive patients undergoing ACDF followed by PSIF crossing the cervico-thoracic junction at a single institution was performed.

Patients underwent either same day (group A) or staged with one week interval surgeries (group B). The minimum follow-up was 12 months.

Results

Thirty-five patients (14 females and 21 males) were analyzed. The average age was 60 years (37–82 years). There were 12 patients in group A and 23 in group B. Twenty-eight complications noted in 14 patients (40%) included: dysphagia in 13 (37%), dysphonia in 6 (17%), post-operative reintubation in 4 (11%), vocal cords paralysis, delirium, superficial incisional infection and cerebrospinal fluid leakage each in one case. Significant differences comparing group A vs. B were found in: the number of levels fused posteriorly (5 vs. 7; p=0.002), total amount of intravenous fluids (3233ml vs. 4683ml; p=0.03), length of hospital stay (10 vs. 18 days; p=0.03) and transfusion of blood products (0 vs. 9 patients). Smoking and cervical myelopathy were the most important risk factors for perioperative complications regardless of the group.

Conclusions

Staging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications.

Abstract

Introduction

Multilevel cervical pathology may be treated via combined anterior cervical decompression and fusion (ACDF) followed by posterior spinal instrumented fusion (PSIF) crossing the cervico-thoracic junction.

The purpose of the study was to compare perioperative complication rates following staged versus same day ACDF combined with PSIF crossing the cervico-thoracic junction.

Material and methods

A retrospective review of consecutive patients undergoing ACDF followed by PSIF crossing the cervico-thoracic junction at a single institution was performed.

Patients underwent either same day (group A) or staged with one week interval surgeries (group B). The minimum follow-up was 12 months.

Results

Thirty-five patients (14 females and 21 males) were analyzed. The average age was 60 years (37–82 years). There were 12 patients in group A and 23 in group B. Twenty-eight complications noted in 14 patients (40%) included: dysphagia in 13 (37%), dysphonia in 6 (17%), post-operative reintubation in 4 (11%), vocal cords paralysis, delirium, superficial incisional infection and cerebrospinal fluid leakage each in one case. Significant differences comparing group A vs. B were found in: the number of levels fused posteriorly (5 vs. 7; p=0.002), total amount of intravenous fluids (3233ml vs. 4683ml; p=0.03), length of hospital stay (10 vs. 18 days; p=0.03) and transfusion of blood products (0 vs. 9 patients). Smoking and cervical myelopathy were the most important risk factors for perioperative complications regardless of the group.

Conclusions

Staging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications.

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Keywords

Perioperative complication, Cervical spine, Instrumented fusion, Decompression

About this article
Title

Comparison of perioperative complications following staged versus one-day anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 48, No 6 (2014)

Pages

403-409

DOI

10.1016/j.pjnns.2014.10.001

Bibliographic record

Neurol Neurochir Pol 2014;48(6):403-409.

Keywords

Perioperative complication
Cervical spine
Instrumented fusion
Decompression

Authors

Kris Siemionow
Marcin Tyrakowski
Kushal Patel
Sergey Neckrysh

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