Complex Revision Surgery for Cervical Deformity or Implant Failure

Abstract

Postoperative cervical deformity sometimes occurs in the short or long term after primary surgery for cervical disorders related to the degenerative aging spine, neoplastic etiologies, hemodialysis, infection, inflammation, trauma, etc. Cervical kyphosis after posterior decompression surgery, such as laminectomy or laminoplasty, is a common problem for spine surgeons. However, revision surgery for cervical deformity is definitely one of the most challenging areas for spine surgeons. There is no doubt that surgery for cervical deformity carries a high risk of surgery-related complications that might result in aggravation of healthrelated quality of life. Revision surgery is even more challenging. Hence, spine surgeons need to assess carefully the overall severity of the underlying condition before revision surgery, and try to refine the surgical strategy to secure safe surgery. Needless to say, spine surgeons are now facing great challenges in making spine surgery a much more reliable and convincing entity.

Development and External Validation of a Risk Calculator for Prediction of Major Complications and Readmission After Anterior Cervical Discectomy and Fusion

“…Implant complications may be associated with pseudarthrosis leading to screw breakage, screws backing out of the plate, and failure of the construct leading to recurrent or worsened symptoms. Revision cervical spinal surgery after implant failure is technically challenging due to dissection through scar tissue and limited bone stock; it is associated with a significantly higher risk of perioperative complications compared with the index surgery 46. In addition, history of complications in past hospital admissions ( e.g., excessive transfusion requirement and wound infection) is important to model performance.…”

“…Revision cervical spinal surgery after implant failure is technically challenging due to dissection through scar tissue and limited bone stock; it is associated with a significantly higher risk of perioperative complications compared with the index surgery. 46 In addition, history of complications in past hospital admissions (e.g., excessive transfusion requirement and wound infection) is important to model performance. This is an intuitive finding suggesting that past hospitalization-associated complications are likely correlated with future complications.…”

Factors Affecting Postoperative Complications and Outcomes of Cervical Spondylotic Myelopathy with Cerebral Palsy : A Retrospective Analysis

“…Recent advances in medical technology have led to the development of improved internal fixation methods, which promote stronger initial mechanical stability resulting from anterior plating or posterior screw fixation [ 7 ]. CSM surgery remains challenging, owing to the complexity of the deformity [ 8 , 20 , 27 , 28 ]. Additionally, involuntary neck movements after surgical treatment can worsen neurological symptoms or further complications associated with surgical implants, frequently leading to poor long-term prognoses [ 12 ].…”

Efficacy for Whitlockite for Augmenting Spinal Fusion

“…In spinal fusion surgery, bone graft materials are used between adjacent bones to facilitate fusion. Autologous bone graft is the gold-standard material for bone fusion, because it has characteristics necessary for new bone formation, such as osteoconductivity, osteoinductivity, and osteogenicity [ 4 , 5 , 6 , 7 ]. However, autologous bone grafts have several complications related to donor-site morbidity, including infection, pain, hematoma, and sensory deficits [ 8 , 9 , 10 ].…”