title: Increased incidence of emergency airway management after combined anterior-posterior cervical spine surgery.
abstract: Among some kinds of cervical spine surgeries, combined anterior-posterior cervical spine surgery (CAP-CS surgery) requires prolonged operative time and highly invasive procedure. This study was performed to determine whether CAP-CS surgery was associated with increased risk of emergency airway management compared with other cervical spine surgeries (O-CS surgeries). The records of the patients who underwent cervical spine surgery between July 2001 and March 2003 at our institution were reviewed retrospectively, and we determined whether the CAP-CS surgery was associated with an increased risk of emergency airway management in comparison with O-CS surgeries, using the logistic regression analysis. A total of 165 were eligible for inclusion in the study. A total of 127, 20, 11, 5, and 2 patients suffered from cervical myelopathy, traumatic cervical spinal cord injury, atlantoaxial dislocation, cervical spinal tumors, and cervical pyogenic spondylitis, respectively. The operative approaches were CAP-CS surgery, anterior surgery, posterior surgery, and atlantoaxial surgery in 10, 56, 88, and 11 patients, respectively. Thus, the operative approaches were CAP-CS surgery in 10 patients and O-CS surgeries in 155 patients. Postoperative emergency airway management was required in 7 of the 10 patients (70%) who underwent CAP-CS surgery, and 2 of the 155 patients (1%) who underwent O-CS surgeries. The increased risk of postoperative emergency airway management imposed by CAP-CS surgery was 178.5 by an odds ratio, with a 95% confidence interval of 25.6 to 1246. The results show that CAP-CS surgery provides a major risk factor for postoperative emergency airway management.
authors.affiliation: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo, Nagasaki, Japan. yoterao@na-robyo.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Terao
authors.forename: Shuhei
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamashita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takada
authors.forename: Chiaki
authors.initials: C
authors.lastname: Inadomi
authors.forename: Makoto
authors.initials: M
authors.lastname: Fukusaki
authors.forename: Koji
authors.initials: K
authors.lastname: Sumikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012306:Risk; D013131:Spine / Q000601:surgery*