Nationwide sample data analysis of additional surgery rate after anterior or posterior cervical spinal surgery

Yuh, Woon Tak; Kim, Minjung; Choi, Yunhee; Han, Ju Hee; Junhoe, Kim,; Kim, Taeshin; Chung, Chun Kee; Lee, Chang‐Hyun; Park, Sung Bae; Kim, Kyoung‐Tae; Rhee, John M.; Park, Moon Soo; Kim, Chi Heon

doi:10.1038/s41598-023-33588-z

Cited by 2 publications

(1 citation statement)

References 60 publications

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“…Posterior approaches report complications such as instability and kyphosis. Surgeons usually prefer an anterior approach due to the lower incidence of complications [ 2 , 52 ]. A systematic review of 60 studies by Tetreault et al [ 53 ] found that age is the only significant predictor of complications.…”

Section: Reviewmentioning

confidence: 99%

Degenerative Cervical Myelopathy: An Overview

Saunders,

Sandhu,

McBride

et al. 2023

Cureus

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Degenerative cervical myelopathy (DCM) is a spinal condition of growing importance due to its increasing prevalence within the ageing population. DCM involves the degeneration of the cervical spine due to various processes such as disc ageing, osteophyte formation, ligament hypertrophy or ossification, as well as coexisting congenital anomalies. This article provides an overview of the literature on DCM and considers areas of focus for future research. A patient with DCM can present with a variety of symptoms ranging from mild hand paraesthesia and loss of dexterity to a more severe presentation of gait disturbance and loss of bowel/bladder control. Hoffman’s sign and the inverted brachioradialis reflex are also important signs of this disease. The gold standard imaging modality is MRI which can identify signs of degeneration of the cervical spine. Other modalities include dynamic MRI, myelography, and diffusion tensor imaging. One important scoring system to aid with the diagnosis and categorisation of the severity of DCM is the modified Japanese Orthopaedic Association score. This considers motor, sensory, and bowel/bladder dysfunction, and categorises patients into mild, moderate, or severe DCM. DCM is primarily treated with surgery as this can halt disease progression and may even allow for neurological recovery. The surgical approach will depend on the location of degeneration, the number of cervical levels involved and the pathophysiological process. Surgical approach options include anterior cervical discectomy and fusion, corpectomy, or posterior approach (laminectomy ± fusion). Conservative management is also considered for some patients with mild or non-progressive DCM or for patients where surgery is not an option. Conservative treatment may include physical therapy, traction, or neck immobilisation. Future recommendations include research into the prevalence rate of DCM and if there is a difference between populations. Further research on the benefit of conservative management for patients with mild or non-progressive DCM would be recommended.

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Section: Reviewmentioning

confidence: 99%

Degenerative Cervical Myelopathy: An Overview

Saunders,

Sandhu,

McBride

et al. 2023

Cureus

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Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Kim,

Park

et al. 2023

J Minim Invasive Spine Surg Tech

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Objective: Posterior full-endoscopic cervical foraminotomy/discectomy (PECF) is used to treat medically intractable cervical radiculopathy. PECF has many potential advantages; however, despite its minimally invasive nature, complications of PECF are possible, including hemorrhage, infection, injury to neural tissue, damage to the facet joint and musculature, loss of cervical lordosis, and subsequent progression to cervical kyphosis. We examined complications following PECF and reviewed the relevant literature.Methods: We retrospectively reviewed 101 patients who underwent PECF for either disc herniation (DH, 59 patients) or foraminal stenosis (FS, 42 patients). After surgery, the patients were encouraged to ambulate and were discharged 2–3 days later without the use of a neck collar. Events occurring during hospitalization were documented in the hospital information system. Patients were followed-up for a mean period of 21±26 months (range, 1–110 months).Results: Clinical parameters improved from 1 month postoperatively and were maintained throughout the follow-up period, with no significant differences between the DH and FS groups (p>0.05). Complications occurred in 14 patients (14%) with no significant difference between the DH (8 of 59, 14%) and FS (6 of 42, 14%) groups (p>0.05). The most common complication was dural tear, followed by motor weakness, sensory changes, hematoma collection, incomplete decompression, reoperation, and wrong-level surgery. Two patients underwent reoperation due to symptomatic hematoma collection and symptom recurrence 3 years postoperatively.Conclusion: The incidence of complications following PECF was 14%. Although most were transient, an understanding of both reported and unreported complications, along with thorough preparation, could reduce the occurrence of PECF-associated complications.

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Nationwide sample data analysis of additional surgery rate after anterior or posterior cervical spinal surgery

Cited by 2 publications

References 60 publications

Degenerative Cervical Myelopathy: An Overview

Degenerative Cervical Myelopathy: An Overview

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

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