[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.


CONCLUSIONS
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.
Zhao
Jun
J
Department of Orthopaedics, the First Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, 400016, PR China. zhaojunmedicine@sina.com
Quan
Zhengxue
Z
Ou
Yunsheng
Y
Jiang
Dianming
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*