Yee Timothy J, Swong Kevin, Park Paul
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
J Spine Surg. 2020 Mar;6(1):302-322. doi: 10.21037/jss.2020.01.14.
The anterior approach to the cervical spine is commonly utilized for a variety of degenerative, traumatic, neoplastic, and infectious indications. While many potential complications overlap with those of the posterior approach, the distinct anatomy of the anterior neck also presents a unique set of hazards. We performed a systematic review of the literature to assess the etiology, presentation, natural history, and management of these complications. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a PubMed search was conducted to evaluate clinical studies and case reports of patients who suffered a complication of anterior cervical spine surgery. The search specifically included articles concerning adult human subjects, written in the English language, and published from 1989 to 2019. The PubMed search yielded 240 articles meeting our criteria. The overall rates of complications were as follows: dysphagia 5.3%, esophageal perforation 0.2%, recurrent laryngeal nerve palsy 1.3%, infection 1.2%, adjacent segment disease 8.1%, pseudarthrosis 2.0%, graft or hardware failure 2.1%, cerebrospinal fluid leak 0.5%, hematoma 1.0%, Horner syndrome 0.4%, C5 palsy 3.0%, vertebral artery injury 0.4%, and new or worsening neurological deficit 0.5%. Morbidity rates in anterior cervical spine surgery are low. Nevertheless, the unique anatomy of the anterior neck presents a wide variety of potential complications involving vascular, aerodigestive, neural, and osseous structures.
颈椎前路手术常用于多种退行性、创伤性、肿瘤性和感染性疾病。虽然许多潜在并发症与后路手术的并发症重叠，但颈前部独特的解剖结构也存在一系列独特的风险。我们对文献进行了系统综述，以评估这些并发症的病因、表现、自然病程和处理方法。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在PubMed上进行了检索，以评估接受颈椎前路手术并出现并发症的患者的临床研究和病例报告。检索特别纳入了有关成年人类受试者、用英文撰写且于1989年至2019年发表的文章。PubMed检索得到240篇符合我们标准的文章。并发症的总体发生率如下：吞咽困难5.3%，食管穿孔0.2%，喉返神经麻痹1.3%，感染1.2%，相邻节段疾病8.1%，假关节形成2.0%，移植物或内固定失败2.1%，脑脊液漏0.5%，血肿1.0%，霍纳综合征0.4%，C5神经麻痹3.0%，椎动脉损伤0.4%，以及新发或加重的神经功能缺损0.5%。颈椎前路手术的发病率较低。然而，颈前部独特的解剖结构存在涉及血管、气消化道、神经和骨骼结构的多种潜在并发症。
