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. 2017 Oct-Dec;8(4):342-349.
doi: 10.4103/jcvjs.JCVJS_61_17.

Perioperative complications in patients treated with posterior cervical fusion and bilateral cages

Krzysztof B Siemionow  1 , Pawel Glowka  1   2 , Robert J Blok  3 , Mark C Gillespy  4 , Mukund I Gundanna  5 , William D Smith  6 , Zeshan Hyder  7 , Bruce M McCormack  8
Affiliations

Perioperative complications in patients treated with posterior cervical fusion and bilateral cages

Krzysztof B Siemionow et al. J Craniovertebr Junction Spine. 2017 Oct-Dec.

Abstract

Context: Posterior cervical cages have recently become available as an alternative to lateral mass fixation in patients undergoing cervical spine surgery.

Aims: The purpose of this study was to quantify the perioperative complications associated with cervical decompression and fusion in patients treated with a posterior cervical fusion (PCF) and bilateral cages.

Settings and design: A retrospective, multicenter review of prospectively collected data was performed at 11 US centers.

Subjects and methods: The charts of 89 consecutive patients with cervical radiculopathy treated surgically at one level with PCF and cages were reviewed. Three cohorts of patients were included standalone primary PCF with cages, circumferential surgery, and patients with postanterior cervical discectomy and fusion pseudarthrosis. Follow-up evaluation included clinical status and pain scale (visual analog scale).

Statistical analysis used: The Wilcoxon test was used to test the differences for the data. The P level of 0.05 was considered significant.

Results: The mean follow-up interval was 7 months (range: 62 weeks - 2 years). The overall postsurgery complication rate was 4.3%. There were two patients with neurological complications (C5 palsy, spinal cord irritation). Two patients had postoperative complications after discharge including one with atrial fibrillation and one with a parietal stroke. After accounting for relatedness to the PCF, the overall complication rate was 3.4%. The average (median) hospital stay for all three groups was 29 h.

Conclusions: The results of our study show that PCF with cages can be considered a safe alternative for patients undergoing cervical spine surgery. The procedure has a favorable overall complication profile, short length of stay, and negligible blood loss.

Keywords: Cervical cage; cervical radiculopathy; cervical spondylosis; complications; posterior cervical fusion; pseudarthrosis.

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Conflict of interest statement

K. Siemionow has a financial interest in Providence Medical Technology. The following authors received funding for medical chart review and data collection: Robert J Blok, Mark C Gillespy, Mukund I Gundanna, William D Smith, Zeshan Hyder, Bruce M McCormack.

Figures

Figure 1
Figure 1
(a and b). Anteroposterior and lateral X-rays of a patient who underwent anterior cervical discectomy and fusion, which resulted in pseudarthrosis. The patient was revised with posterior cervical fusion with bilateral cages
Figure 2
Figure 2
Level of surgery for each patient
Figure 3
Figure 3
Comorbidities
Figure 4
Figure 4
Length of stay
Figure 5
Figure 5
Estimated blood loos
See this image and copyright information in PMC

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