Complications during and after surgery of the lower cervical spine by isolated anterior approach with CSLP implant.
BACKGROUND
The merits of different operative approaches in the management of spinal injury is debated. The aim of this study was to assess, retrospectively, the outcome of treatment of injuries of the lower cervical spine by an anterior approach, in terms of fusion rate and complications.


METHODS
Between 1995 and 2004, 270 patients with an injury of the lower cervical spine were operated on by an anterior approach in our hospital. There were 67 females and 203 males. Using the Aebi and Nazarian classification, 22% of patients had a type A injury, 23% of patients had a type B injury and 55% of patients had a type C injury. All had an anterior approach with monocortical stabilisation using a cervical spine locking plate [Synthes].


RESULTS
Radiological evidence of fusion was found in all but one patient at 6 months. Complications occurred in a small proportion of the series. Recurrent laryngeal nerve injury was noted in seven patients, an abscess in the wound in one patient, a haematoma requiring re-operation for evacuation in two patients. The cervical locking plate broke in one patient and this patient went on to develop a pseudoarthrosis from failure to fuse. In another patient there was release of the plate osteosynthesis.


CONCLUSIONS
Treatment of the injured lower cervical spine by an anterior operation and plate fixation was successful in achieving bone fusion in almost every patient and was followed by a complication in only a small proportion of our series. Similar results in other reports indicate that this approach is a safe and effective procedure.
Kocis
J
J
Department of Trauma, Masaryk University, Brno, Czech Republic. jankocis@seznam.cz
Wendsche
P
P
Veselý
R
R
Hart
R
R
Cizmár
I
I
D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects / Q000592:standards; D002574:Cervical Vertebrae / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D019736:Prostheses and Implants / Q000009:adverse effects / Q000592:standards; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D017211:Treatment Failure; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000517:prevention & control