scholarly journals Corticosteroid Administration to Prevent Complications of Anterior Cervical Spine Fusion: A Systematic Review

2017 ◽  
Vol 8 (3) ◽  
pp. 286-302 ◽  
Author(s):  
Shayan Abdollah Zadegan ◽  
Seyed Behnam Jazayeri ◽  
Aidin Abedi ◽  
Hirbod Nasiri Bonaki ◽  
Alexander R. Vaccaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Airway Compromise ◽  
Corticosteroid Administration ◽  
Cervical Spine Surgery ◽  
Randomized Controlled ◽  
Anterior Cervical Spine Surgery

Study Design: Systematic review. Objectives: Anterior cervical approach is associated with complications such as dysphagia and airway compromise. In this study, we aimed to systematically review the literature on the efficacy and safety of corticosteroid administration as a preventive measure of such complications in anterior cervical spine surgery with fusion. Methods: Following a systematic literature search of MEDLINE, Embase, and Cochrane databases in July 2016, all comparative human studies that evaluated the effect of steroids for prevention of complications in anterior cervical spine surgery with fusion were included, irrespective of number of levels and language. Risk of bias was assessed using MINORS (Methodological Index for Non-Randomized Studies) checklist and Cochrane Back and Neck group recommendations, for nonrandomized and randomized studies, respectively. Results: Our search yielded 556 articles, of which 9 studies (7 randomized controlled trials and 2 non–randomized controlled trials) were included in the final review. Dysphagia was the most commonly evaluated complication, and in most studies, its severity or incidence was significantly lower in the steroid group. Although prevertebral soft tissue swelling was less commonly assessed, the results were generally in favor of steroid use. The evidence for airway compromise and length of hospitalization was inconclusive. Steroid-related complications were rare, and in both studies that evaluated the fusion rate, it was comparable between steroid and control groups in long-term follow-up. Conclusions: Current literature supports the use of steroids for prevention of complications in anterior cervical spine surgery with fusion. However, evidence is limited by substantial risk of bias and small number of studies reporting key outcomes.

scholarly journals Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature

2016 ◽  
Vol 25 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Sameer H. Halani ◽  
Griffin R. Baum ◽  
Jonathan P. Riley ◽  
Gustavo Pradilla ◽  
Daniel Refai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Spinal Surgery ◽  
Esophageal Injury ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Pubmed Search ◽  
Anterior Spinal Surgery

OBJECTIVE Esophageal perforation is a rare but well-known complication of anterior cervical spine surgery. The authors performed a systematic review of the literature to evaluate symptomatology, direct causes, repair methods, and associated complications of esophageal injury. METHODS A PubMed search that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included relevant clinical studies and case reports (articles written in the English language that included humans as subjects) that reported patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. Available data on clinical presentation, the surgical procedure performed, outcome measures, and other individual variables were abstracted from 1980 through 2015. RESULTS The PubMed search yielded 65 articles with 153 patients (mean age 44.7 years; range 14–85 years) who underwent anterior spinal surgery and sustained esophageal perforation, either during surgery or in a delayed fashion. The most common indications for initial anterior cervical spine surgery in these cases were vertebral fracture/dislocation (n = 77), spondylotic myelopathy (n = 15), and nucleus pulposus herniation (n = 10). The most commonly involved spinal levels were C5–6 (n = 51) and C6–7 (n = 39). The most common presenting symptoms included dysphagia (n =63), fever (n = 24), neck swelling (n = 23), and wound leakage (n = 18). The etiology of esophageal perforation included hardware failure (n = 31), hardware erosion (n = 23), and intraoperative injury (n = 14). The imaging modalities used to identify the esophageal perforations included modified contrast dye swallow studies, CT, endoscopy, plain radiography, and MRI. Esophageal repair was most commonly achieved using a modified muscle flap, as well as with primary closure. Outcomes measured in the literature were often defined by the time to oral intake following esophageal repair. Complications included pneumonia (n = 6), mediastinitis (n = 4), osteomyelitis (n = 3), sepsis (n = 3), acute respiratory distress syndrome (n = 2), and recurrent laryngeal nerve damage (n = 1). The mortality rate of esophageal perforation in the analysis was 3.92% (6 of 153 reported patients). CONCLUSIONS Esophageal perforation after anterior cervical spine surgery is a rare complication. This systematic review demonstrates that these perforations can be stratified into 3 categories based on the timing of symptomatic onset: intraoperative, early postoperative (within 30 days of anterior spinal surgery), and delayed. The most common source of esophageal injury is hardware erosion or migration, each of which may vary in their time to symptomatic manifestation.

scholarly journals Effect of perioperative steroids on dysphagia after anterior cervical spine surgery: A systematic review

10.14444/4009 ◽  
2017 ◽  
Vol 11 (2) ◽  
pp. 9 ◽  
Author(s):  
Abidemi S. Adenikinju ◽  
Sameer H. Halani ◽  
Rima S. Rindler ◽  
Matthew F. Gary ◽  
Keith W. Michael ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

scholarly journals Pharyngo-Esophageal Perforation Following Anterior Cervical Spine Surgery: A Single Center Experience and a Systematic Review of the Literature

2021 ◽  
pp. 219256822110057
Author(s):  
Lucia Moletta ◽  
Elisa Sefora Pierobon ◽  
Renato Salvador ◽  
Francesco Volpin ◽  
Francesco Massimiliano Finocchiaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
English Literature ◽  
Case Series ◽  
Review Of The Literature ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Fixation Devices

Study Design: Case series and systematic review of the Literature. Objectives: Pharyngo-esophageal perforation (PEP) is a rare, life-threatening complication of anterior cervical spine surgery (ACSS). Best management of these patients remains poorly defined. The aim of this study is to present our experience with this entity and to perform a systematic Literature review to better clarify the appropriate treatment of these patients. Methods: Patients referred to our center for PEP following ACSS (January 2002-December 2018) were identified from our database. Moreover, an extensive review of the English Literature was conducted according to the 2009 PRISMA guidelines. Results: Twelve patients were referred to our Institution for PEP following ACSS. Indications for ACSS were trauma (n = 10), vertebral metastases (n = 1) and disc herniation (n = 1). All patients underwent hardware placement at the time of ACSS. There were 6 early and 6 delayed PEP. Surgical treatment was performed in 11 patients with total or partial removal of spine fixation devices, autologous bone graft insertion or plate/cage replacement, anatomical suture of the fistula and suture line reinforcement with myoplasty. Complete resolution of PEP was observed in 6 patients. Five patients experienced PEP persistence, requiring further surgical management in 2 cases. At a median follow-up of 18.8 months, all patients exhibited permanent resolution of the perforation. Conclusions: PEP following ACSS is a rare but dreadful complication. Partial or total removal of the fixation devices, direct suture of the esophageal defect and coverage with tissue flaps seems to be an effective surgical approach in these patients

Vocal cord palsy after anterior cervical spine surgery: a qualitative systematic review

2014 ◽  
Vol 14 (7) ◽  
pp. 1332-1342 ◽  
Author(s):  
Tze P. Tan ◽  
Arun P. Govindarajulu ◽  
Eric M. Massicotte ◽  
Lashmi Venkatraghavan
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Vocal Cord ◽  
Spine Surgery ◽  
Vocal Cord Palsy ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Qualitative Systematic Review
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