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. 2017 Apr;7(1 Suppl):53S-57S.
doi: 10.1177/2192568216687547. Epub 2017 Apr 1.

Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study

Ziya L Gokaslan  1   2   3   4 , Mohamad Bydon  5 , Rafael De la Garza-Ramos  6 , Zachary A Smith  7 , Wellington K Hsu  7 , Sheeraz A Qureshi  8 , Samuel K Cho  8 , Evan O Baird  8 , Thomas E Mroz  9 , Michael Fehlings  10 , Paul M Arnold  11 , K Daniel Riew  12   13
Affiliations

Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study

Ziya L Gokaslan et al. Global Spine J. 2017 Apr.

Abstract

Study design: Multicenter retrospective study.

Objectives: To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes.

Methods: A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patients were included if they underwent cervical spine surgery (levels from C2 to C7) between January 1, 2005 and December 31, 2011. Data were analyzed with regard to complication treatment and outcome. Cases were compared to a control group from the AOSpine CSM and CSM-I studies.

Results: Three centers reported 19 cases of RLNP from a cohort of 1345 patients. The reported incidence of RLNP ranged from 0.6% to 2.9% between these 3 centers. Fifteen patients (79%) in the RLNP group were approached from the left side. Ten patients (52.6%) required treatment for RLNP-6 required medical therapy (steroids), 1 interventional treatment (injection laryngoplasty), and 3 conservative therapy (speech therapy). When examining outcomes, 73.7% (14/19) of cases resolved completely, 15.8% (3/19) resolved with residual effects, and in 10.5% (2/19) of cases this could not be determined.

Conclusions: In this multicenter study examining rare complications following cervical spine surgery, the risk of RLNP after cervical spine surgery ranged from 0.6% to 2.9% between centers. Though rare, it was found that 16% of patients may experience partial resolution with residual effects, and 74% resolve completely.

Keywords: cervical spine; multicenter study; recurrent laryngeal nerve palsy; spine surgery; vocal cord paralysis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Ziya L. Gokaslan reports grants from AOSpine North America, personal fees from AO Foundation, grants from AOSpine, outside the submitted work; Zachary A. Smith reports grants from AOSpine North America during the conduct of the study; Wellington K. Hsu reports grants from AOSpine North America during the conduct of the study, personal fees from Medtronic, personal fees from Stryker, personal fees from Bacterin, personal fees from Graftys, personal fees from Ceramtec, personal fees from Relievant, personal fees from Bioventus, personal fees from Globus, personal fees from SpineSmith, outside the submitted work; Sheeraz A. Qureshi reports grants from AOSpine North America during the conduct of the study, and is a consultant and receive royalties from Stryker Spine, Biomet Spine, and RTI; Thomas E. Mroz reports other from AOSpine, during the conduct of the study, personal fees from Stryker, personal fees from Ceramtec, other from Pearl Diver, outside the submitted work; Michael Fehlings reports grants from AOSpine North America during the conduct of the study; and K. Daniel Riew reports personal fees from AOSpine International, other from Global Spine Journal, other from Spine Journal, other from Neurosurgery, personal fees from Multiple Entities for defense, plantiff, grants from AOSpine, grants from Cerapedics, grants from Medtronic, personal fees from AOSpine, personal fees from NASS, personal fees from Biomet, personal fees from Medtronic, nonfinancial support from Broadwater, outside the submitted work; Mohamad Bydon reports grants from AOSpine North America during the conduct of the study; Rafael De la Garza-Ramos reports grants from AOSpine North America during the conduct of the study; Samuel K. Cho Dr. Cho reports grants from AOSpine North America during the conduct of the study; grants from OREF, personal fees from Stryker, personal fees from Medtronic, personal fees from DePuy Synthes, outside the submitted work; Evan O. Baird reports grants from AOSpine North America during the conduct of the study; Paul M. Arnold Paul M. Arnold reports grants from AOSpine North America, during the conduct of the study; other from Z-Plasty, other from Medtronic Sofamore Danek, other from Stryker Spine, other from FzioMed, other from AOSpine North America, other from Life Spine, other from Integra Life, other from Spine Wave, other from MIEMS, other from Cerapedics, other from AOSpine North America, outside the submitted work.

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