Surgical complications associated with multilevel anterior cervical decompression and fusion technique in a large prospective study

Abstract

This study describes our experience with the treatment of cervical degenerative pathology through anterior cervical decompression and fusion technique. We evaluated the clinical outcome and complications after 6-months follow-up and analysed the data to optimize the efficacy and safety of this particular surgical treatment in order to minimize the risks of complications. The presented study included 111 patients (74 men and 37 women; mean age 56.5 years) treated in the Neurosurgical Department of UMBAL Sv. Ivan Rilski Hospital in Sofia, Bulgaria, for cervical degenerative multilevel pathology with myelopathy. The operations included only anterior cervical approach with single-level or multilevel corpectomy, considering the pathology and neurological deficit in each particular case, followed by instrumented fusion with titanium mesh and locking plates. We analysed the data for intraoperative, early and late postoperative complications and the neurological results were examined and compared with the aid of Nurick and mJOA scales for myelopathy. The mean mJOA score preoperatively was 11.37 (SD ± 2.63) and postoperatively the mean mJOA score was 13.27 (SD ± 2.61), p < 0.0001. Since the emerging of this technique more than 50 years ago, it has improved in many ways, although there are still some contradictory results. Still, the most important aspect should be to consider the individual's pathology in order to better understand the underlying problems and think of ways to resolve them appropriately.

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

“…The dural tear is one of the relatively few complications, as it occurred in the current study at a rate of 0.9% in a patient who underwent ACCF surgery. Mihaylova et al (2020) reported a dural tear rate of 2.7%, all of which occurred in patients who underwent ACCF surgery. Thickening or calcification of PLL significantly increases the risk of dural tear.…”