Peri-surgical Complications Related to Anterior Cervical Spine Surgery: Smith-Robinson Approach

Abstract

The primary goal is to identify the genuine incidence of peri-surgical complications associated with anterior cervical spine surgery in a low-income country. The secondary goal is to identify any risk factors predisposed to these complications; Especially dysphagia, as it is the most common perioperative complication, and to clarify the prognosis of these complications, as well as their proper management. This is a retrospective case-control study, including 109 patients who underwent anterior cervical spine intervention from the right side in Tishreen University Hospital in Lattakia, Syria, during the period between 1-1-2018 and 15-12-2021. Data was collected regarding gender, age, diagnosis (radiculopathy or myelopathy), surgical procedure, number of levels, plate addition, smoking, diabetes mellitus, and peri-surgical complications occurred during surgery proceeding to the next 14 days of follow-up. Male: female ratio was (1.4:1), 30.3% of cases were from a grouping (41-50) years of age. Myelopathy consists 56% of cases, anterior cervical discectomy and fusion (ACDF) consist of 47.7% of procedures. Intervention at one level represented the highest percentage at 52% of cases. The peri-surgical complication rate was 12.8%; divided into dysphagia 6.4%, recurrent laryngeal nerve (RLN) injury, superficial infection 1.8% each, dural tear, compressive hematoma, and neurological deterioration 0.9% each. Plate addition, 3 or more levels of intervention, and (ACDF+P) or (ACCF) surgery are all determined to be risk factors for the development of perioperative dysphagia. The majority of peri-surgical complications of anterior cervical spine surgery are minor and can be managed conservatively with a good prognosis. Early recognition of these complications with appropriate management is of paramount importance for improving the outcomes. Plate addition, 3 or more levels of intervention, and (ACDF+P) or (ACCF) surgery are all determined to be risk factors for the development of perioperative dysphagia.