Early dysphagia complicating anterior cervical spine surgery: incidence and risk factors

Abstract Background We aim to explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery. Methods The clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by the senior author from January 2011 to December 2017 were evaluated. Multivariate logistic regression was conducted to compare the hematoma group and the no-hematoma group to determine which factors were independently associated with hematoma formation in patients who need evacuation. The Mann-Whitney U test was conducted to compare the Neck Disability Index score in the two groups. Results A total of 678 patients met the criteria and underwent anterior cervical spine surgery. Thirteen patients undergone hematoma evacuation. Multivariate logistic regression analysis identified that history of hypertension (p = 0.039 OR = 4.42 95% CI 1.08–18.07) and therapeutic heparin use (p = 0.020 OR = 4.58 95% CI 1.27–16.59) were independent risk factors for hematoma formation. The t-test showed no significant differences between the hematoma group and the no-hematoma group in terms of APTT or PT levels (p > 0.05). The Mann-Whitney U test indicated that there was no difference in NDI scores between the two groups(p > 0.05). Conclusion History of hypertension and therapeutic heparin use are risk factors for hematoma formation. Meticulous hemostasis, moderate muscle subtraction, and perioperative airway management are critical for avoiding hematoma development. The Neck Hematoma Scores can quickly determine the severity of a hematoma in the absence of radiographic image evidence.

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Vocal Fold Paralysis After Anterior Cervical Spine Surgery: Incidence, Mechanism, and Prevention of Injury

The Laryngoscope ◽

10.1097/00005537-200009000-00011 ◽

2000 ◽

Vol 110 (9) ◽

pp. 1467-1473 ◽

Cited By ~ 79

Author(s):

Mark D. Kriskovich ◽

Ronald I. Apfelbaum ◽

Jeffrey R. Haller

Keyword(s):

Cervical Spine ◽

Spine Surgery ◽

Vocal Fold ◽

Vocal Fold Paralysis ◽

Cervical Spine Surgery ◽

Anterior Cervical Spine Surgery ◽

Surgery Incidence

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Risk factors for dysphagia after anterior cervical spine surgery: a two-year prospective cohort study

The Spine Journal ◽

10.1016/j.spinee.2006.02.024 ◽

2007 ◽

Vol 7 (2) ◽

pp. 141-147 ◽

Cited By ~ 154

Author(s):

Michael J. Lee ◽

Raj Bazaz ◽

Christopher G. Furey ◽

Jung Yoo

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Cervical Spine ◽

Prospective Cohort Study ◽

Spine Surgery ◽

Prospective Cohort ◽

Cervical Spine Surgery ◽

Anterior Cervical Spine Surgery

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Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

10.21203/rs.3.rs-50255/v1 ◽

2020 ◽

Author(s):

Chengyue Ji ◽

Yuluo Rong ◽

Jiaxing Wang ◽

Guoyong Yin ◽

Jin Fan ◽

...

Keyword(s):

Risk Factors ◽

Cervical Spine ◽

Spine Surgery ◽

Spinal Canal ◽

Signal Intensity ◽

High Signal Intensity ◽

High Signal ◽

Cervical Spine Surgery ◽

Anterior Cervical Spine Surgery ◽

Surgical Difficulty

Abstract BackgroundFor a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).MethodsThis was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, operation level, high signal intensity on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.ResultsSignificant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), operation level (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that operation level (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.ConclusionThis study indicated that the operational level, OPLL, high signal intensity, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

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