#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Complications of the Anterior Cervical Spine Surgery for a Degenerative Disease


Authors: L. Hrabálek 1;  M. Vaverka 1;  B. Kupka 2;  M. Houdek 1
Authors‘ workplace: Neurochirurgická klinika FN a LF UP Olomouc 1;  Neurologická klinika FN a LF UP Olomouc 2
Published in: Cesk Slov Neurol N 2007; 70/103(2): 201-206
Category: Short Communication

Overview

The anterior approach to the cervical spine has been regarded as considerate and safe and, therefore, it is usually accompanied with few complications. Nevertheless, even seemingly lesser post-operative problems due to a surgical approach or after taking off a bone graft from the innominate bone sometimes interfere with otherwise positive effects of an intervention. The aim of this research is to evaluate character and frequency of the incidence of these troubles.

The outcomes of 255 operations followed up for the minimal period of 2 years were assessed retrospectively. The most frequent complication of the surgical approach to the cervical spine was dysphagia. It occurred in 23.7% patients, and the dependence on the number of operated levels was shown. Statistically significant, more frequent dysphagia occurred in more-level performances and, thus, it was connected with the extent of exposing the anterior surfaces of the spine. Dysphonia appeared in 13.9%, disappeared by 6 months in 12.7%, and persisted only in 1.2% patients. Complications due to the site of the bone-graft sampling were observed in 41.5% patients, they were small in 31.2% patients and large (pain in the sampling site lasting for more than 6 months, permanent meralgia paresthetica, fracture of the innominate bone ridge or abscess in the sampling site) in 10.3% patients.

Key-words:
cervical spine – degenerative disease of the spine – operation – anterior approach – a bone graft sampling - complications


Sources

1. Smith GW, Robinson RA. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Med Soc 1955; 96: 223-4.

2. Bailey RW, Badgley CE. Stabilisation of the cervical spine by anterior fusion. J Bone Point Surg Am 1960; 42: 565-94.

3. Caspar W. Die ventrale intercorporale stabilisierung mit der HWS-Trapez-Osteosyntheseplatte: Indikation, Technik, Ergebnisse. Z Orthop 1981; 119: 809-10.

4. Johnston FG, Crockard HA. One – stage internal fixation and anterior fusion in complex cervical spinal disorders. J Neurosurgery 1995; 82: 234-8.

5. Bertalanffy H, Eggert HR. Complications of anterior cervical discectomy without fusion in 450 consecutive patients. Acta Neurochirurgica 1989; 99: 41-50.

6. Heidecke V, Rainov NG, Burkert W. Anterior cervical fusion with the Orion locking plate system. Spine 1998; 23(16): 1796-1803.

7. Kostuik JP, Conolly PJ, Esses SI, Suh P. Anterior cervical plate fixation with the titanium hollow screw plate system. Spine 1993; 18(10): 1273-8.

8. Apfelbaum RI, Kriskovich MD, Halley JR. On the incidence, cause and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine 2000; 25(22):2906-2912.

9. Ebraheim N, Lu J, Skie M, Heck BE, Yeasting RA. Vulnerability of the recurrent laryngeal nerve in the anterior approach to the lower cervical spine. Spine 1997: 22(22): 2664-7.

10. Kos J. Periferní nervstvo. Systema nervosum periphericum. In: Borovanský L et al. Soustavná anatomie člověka II. 5th ed. Praha: Avicenum: 1976: 950.

11. Gore DR, Sepic SB. Anterior discectomy and fusion for painful cervical disc disease. Spine 1998; 23(19): 2047-51.

12. Grisoli F, Graziani N, Fabrizi AP, Peragut JC, Vincentelli F, Diaz – Vasques P. Anterior discectomy without fusion for treatment of cervical lateral soft disc extrusion: a follow – up of 120 cases. Neurosurgery 1989; 24(6): 853–9.

13. Cuatico W. Anterior cervical discectomy without interbody fusion. An analysis of 81 cases. Acta Neurochirurgica 1981; 57: 269-74.

14. Ebraheim NA, Lu J, Heck BE, Yeasting RA. Vulnerability of the sympathetic trunk during the anterior approach to the lower cervical spine. Spine 2000; 25(13):1603-1.

15. Dubuisson A, Lenelle J, Stevenaert. Soft cervical disc herniation: a retrospective study od l00 cases. Acta Neurochirurgica 1993; 125: 115-9.

16. Rhoten RL, Murphy MA, Kalfas LH, Hahn JF, Washington JA. Antibiotic penetration into cervical discs. Neurosurgery l995; 37(3): 418-421.

17. Vaverka M, Petrželová J. Penetrace antibiotika do intervertebrálního disku. Acta chirurgie orthopaedicae et traumatologie Čechoslovaca 1991; 58(1-2): 98-103.

18. Banwart JCh, Aster MA, Hassanein RS. Iliac crest bone graft harvest donor site morbidity. Spine 1995; 20(9): 1055-60.

19. Kurz LT, Gardin SR, Booth RE. Harvesting autogenous iliac bone grafts: A review of complications and techniques. Spine 1989; 14: 1324-31.

20. Thalgott JS, Fritts K, Giuffre JM, Timlin M. Anterior interbody fusion of the cervical spine with coralline hydroxyapatite. Spine 1999; 24(13): 1296-9.

21. Suchomel P, Barsa P, Buchvald P, Svobodník A, Vaníčková E. Autologous versus allogenic bone grafts in instrumented anterior cervical discectomy and fusion: a prospective study with respect to bone union pattern. Eur Spine J 2004; 13(6): 510-5.

22. Fuller DA, Stevenson S, Emery SE. The effects of internal fixation on calcium carbonate. Spine 1996; 21 (18): 2131-6.

23. Ibanez J, Carreno A, Garcia-Amorena C, Caral J, Gaston F, Ferrer E. Results of the biocompatible osteoconductive polymer (BOP) as an intersomatic graft in anterior cervical surgery. Acta Neurochirurgica 1998; 140: 126-33.

24. Lozes G, Fawas A, Cama A, Krivosic I, Devos P at al. Discectomies of the lower cervical spine using interbody biopolymer (BOP) implants. Acta Neurochirurgica 1989; 96: 88-93.

25. Rudinský B, Hill R. Intervertebrálna fúzia po použití biokeramickej náhrady NZ 2000 ( hydroxyapatit ) pri jeho dvojúrovňovej mikrodisektómii cervikálnej chrbtice. Acta Spondylologica 2002; 1(1): 16-20.

26. Suchomel P, Barsa P. Náhrada krční meziobratlové ploténky vložkou Cespace bez použití kosti či její náhrady. Prospektivní studie. Acta Spondylologica 2004; 3(1): 5-9.

27. Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma 1989; 3: 192-5.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 2

2007 Issue 2

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#