Zekaj Edvin, Iess Guglielmo, Servello Domenico
Department of Neurosurgery, IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy.
Department of Functional Neurosurgery, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Surg Neurol Int. 2021 Feb 3;12:43. doi: 10.25259/SNI_876_2020. eCollection 2021.
Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience.
We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years' experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson's Chi-square and Fisher's test).
The total cumulative complication rate was 15.4% and was not significantly different between the two cohorts. The most frequent postoperative complication was dysphagia. Notably, there were no significant differences in total number of postoperative instances of dysphagia, dysphonia, unintended durotomy, hypoasthenia, and hypoesthesia; the only difference was the longer operative times for NNs.
Surgeons' years of experience proved not to be a critical factor in determining complication rates following anterior cervical surgery.
颈椎前路手术应用广泛。尽管该手术很受欢迎，但可能导致严重的、危及生命的并发症，值得经验丰富的脊柱外科主治医生关注。
我们回顾性评估了2013年至2020年间接受颈椎前路手术（颈椎前路椎间盘切除术不融合、颈椎前路椎间盘切除术融合和颈椎前路椎间盘置换术）的110例患者术后并发症。这些手术由一位有30年经验的主治医生或一位接受该主治医生培训不足5年的新手神经外科医生（NN）进行。通过入院/出院记录、手术报告、随访和电话等方式确定各种并发症。比较两组并发症的总发生率和特定并发症发生率（使用Pearson卡方检验和Fisher检验）。
总累积并发症发生率为15.4%，两组之间无显著差异。最常见的术后并发症是吞咽困难。值得注意的是，吞咽困难、发音障碍、意外硬脊膜切开、肌无力和感觉减退的术后总例数无显著差异；唯一的差异是新手神经外科医生的手术时间更长。
外科医生的经验年限并非决定颈椎前路手术后并发症发生率的关键因素。
