title: Utility of Routine Outpatient Cervical Spine Imaging Following Anterior Cervical Corpectomy and Fusion.
abstract: BACKGROUND
  Construct failure is an uncommon but well-recognized complication following anterior cervical corpectomy and fusion (ACCF). In order to screen for these complications, many centers routinely image patients at outpatient visits following surgery. There remains, however, little data on the utility of such imaging.
  
  
  METHODS
  The electronic medical record of all patients undergoing anterior cervical corpectomy and fusion at Dartmouth-Hitchcock Medical Center between 2004 and 2009 were reviewed. All patients had routine cervical spine radiographs performed perioperatively. Follow-up visits up to two years postoperatively were analyzed.
  
  
  RESULTS
  Sixty-five patients (mean age 52.2) underwent surgery during the time period. Eighteen patients were female. Forty patients had surgery performed for spondylosis, 20 for trauma, three for tumor, and two for infection. Forty-three patients underwent one-level corpectomy, 20 underwent two-level corpectomy, and two underwent three-level corpectomy, using an allograft, autograft, or both. Sixty-two of the fusions were instrumented using a plate and 13 had posterior augmentation. Fifty-seven patients had follow-up with imaging at four to 12 weeks following surgery, 54 with plain radiographs, two with CT scans, and one with an MRI scan. Unexpected findings were noted in six cases. One of those patients, found to have asymptomatic recurrent kyphosis following a two-level corpectomy, had repeat surgery because of those findings. Only one further patient was found to have abnormal imaging up to two years, and this patient required no further intervention.
  
  
  CONCLUSIONS
  Routine imaging after ACCF can demonstrate asymptomatic occurrences of clinically significant instrument failure. In 43 consecutive single-level ACCF however, routine imaging did not change management, even when an abnormality was discovered. This may suggest a limited role for routine imaging after ACCF in longer constructs involving multiple levels.
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine.
authors.forename: Atman
authors.initials: A
authors.lastname: Desai
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine.
authors.forename: Arjun V
authors.initials: AV
authors.lastname: Pendharkar
authors.affiliation: Section of Neurosurgery, Dartmouth-Hitchcock Medical Center.
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Swienckowski
authors.affiliation: Section of Neurosurgery, Dartmouth-Hitchcock Medical Center.
authors.forename: Perry A
authors.initials: PA
authors.lastname: Ball
authors.affiliation: Section of Neurosurgery, Dartmouth-Hitchcock Medical Center.
authors.forename: Scott
authors.initials: S
authors.lastname: Lollis
authors.affiliation: Section of Neurosurgery, Dartmouth-Hitchcock Medical Center.
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Simmons
keywords: corpectomy; follow-up; outpatient; radiograph