[Prevention and treatment of early postoperative complications of anterior cervical spinal surgery].

OBJECTIVE

To study the prevention and management of early complications associated with anterior cervical spinal surgery.

METHODS

From November 1998 to December 2006, 363 cases were treated with anterior cervical surgery, including 268 males and 95 females aged 17-79 years. In these cases, 224 suffered from cervical spondylosis, 39 from cervical disc herniation, 87 from cervical trauma, 9 from cervical tumor and 4 from cervical tuberculosis. Forty-eight cases with anterior cervical surgery were fused by autogenous iliac bones, 132 cases with anterior cervical surgery were fused by autogenous iliac bones and anterior cervical spine locking plates, and 183 cases with anterior cervical surgery were fused by titanium mesh cage and anterior cervical spine locking plates.

RESULTS

A total of 282 cases were followed up for 3 months to 5 years with the average of 1 year and 11 months. Twenty-three complications associated with surgery were found, with an incidence of 8.16%. Three cases of transient superior laryngeal nerve palsy recovered within 3-7 days after the restriction of liquid diet and fluid replacement. Two cases of recurrent laryngeal nerve palsy recovered by 3-month pronunciation practice. One case of spinal cord injury was treated with medicine for dehydration and anti-inflammation, and was restored to preoperative muscle power of inferior extremity after 6 months. Two cases of CSF leakage were cured with moderate local compression and meticulous water-tight wound closure. Among the 10 patients with complications of internal fixation, one suffering mild dysphagia was reoperated, while the others were treated with cephalo-cervico-thorax plaster external fixation and recovered with solid fusion within 3-18 months. Among the 4 cases with cervical hematoma, 1 died of wrong rescue procedures and 1 was infected.

CONCLUSION

Adequate preoperative preparation, thorough understanding of anatomy related to the anterior approach and skilled surgical technique are essential for preventing the early postoperative complications of anterior cervical spinal surgery.