open access
Comparison of perioperative complications following staged versus one-day anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction
- Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, United States
- Department of Orthopaedics, Pediatric Orthopaedics and Traumatology, The Medical Centre of Postgraduate Education, Otwock, Poland
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, United States
open access
Abstract
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 methodsA 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.
ResultsThirty-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.
ConclusionsStaging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications.
Abstract
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 methodsA 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.
ResultsThirty-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.
ConclusionsStaging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications.
Keywords
Perioperative complication, Cervical spine, Instrumented fusion, Decompression
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
Pages
403-409
Page views
407
Article views/downloads
690
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