Early reintervention after anterior cervical spine surgery: Epidemiology and risk factors: A case-control study

• Published in: Orthopaedics & traumatology, surgery & research Vol. 102; no. 4; pp. 485 - 488
• Main Authors: Boudissa, M, Lebecque, J, Boissière, L, Gille, O, Pointillart, V, Obeid, I, Vital, J.-M
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-06-2016
• Subjects: Aged; Anterior cervicotomy; Case-Control Studies; Cervical spine; Epidural hematoma; Female; Health Status; Hematoma, Epidural, Spinal - epidemiology; Hematoma, Epidural, Spinal - surgery; Humans; Incidence; Male; Middle Aged; Orthopedics; Postoperative Complications - epidemiology; Postoperative Complications - surgery; Prevalence; Reoperation; Retropharyngeal hematoma; Retrospective Studies; Risk Factors; Smoking - epidemiology; Surgery; Time Factors; Anterior cervicotomy; Retropharyngeal hematoma; Epidural hematoma; Cervical spine
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2016.02.003

Abstract Introduction Anterior cervical spine surgery is a frequent and effective procedure; complications are rare, but potentially fatal. The objective of the present study was to assess epidemiology and risk factors for early reintervention in anterior cervical spine surgery. Methods A retrospective case-control study recruited 2319 patients operated on in our department, with 7 years’ follow-up. Incidence and prevalence of causes of early reintervention were analyzed. Each case was matched to 2 controls from the same source population. Risk factors were identified and odds ratios (OR) were calculated. Results Thirteen patients (0.6%: 3 female, 10 male; mean age, 59 ± 12 years) underwent surgical reintervention within 72 hours. Causes comprised: retropharyngeal hematoma (0.2%), epidural hematoma (0.3%) and dural breach (0.04%). As risk factor for early reintervention, only ASA score ≥ 3 proved significant (OR: 5.5; 95% confidence interval: 1.1–29.85). As risk factor for epidural hematoma, only smoking proved significant (OR: 14.67; 95% confidence interval: 1.16–185.29). No risk factors emerged for onset of retropharyngeal hematoma. Conclusion ASA score ≥ 3 and smoking entail risk of epidural hematoma and early reintervention. Postoperative pain, neurologic deficit, dysphagia, dysphonia, dyspnea and agitation suggest onset of complications, requiring necessary measures to be taken. Implementation of drainage fails to prevent such complications.