Lightning Podiums: Cervical Degenerative - Room 802A

Presented by: K. Siemionow

Author(s):

K. Siemionow(1), R. Blok(2), M. Gillespy(3), M. Gundanna(4), W. Smith(5), Z. Hyder(6), B. Mc Cormack(7), P. Glowka(1,8)

(1) University of Illinois at Chicago, Department of Orthopaedics, Chicago, IL, United States
(2) Clark Memorial Hospital, Lafayette, IN, United States
(3) Halifax Health Medical Center, Daytona Beach, FL, United States
(4) Brazos Spine Surgery, College Station, TX, United States
(5) Western Regional Brain and Spine, Las Vegas, NV, United States
(6) Orthopedic Spine Surgery, Merrillville, IN, United States
(7) Neuropsine Institute Medical Group, San Francisco, CA, United States
(8) University of Medical Sciences, Department of Spinal Disorders and Pediatric Orthopaedics, Poznan, Poland

Abstract

Background: Posterior cervical cages have recently become available as an alternative to lateral mass fixation (LMF) in patients undergoing cervical spine surgery. The purpose of this study was to quantify the perioperative complications associated with cervical decompression and fusion in patients treated with a posterior cervical fusion (PCF) and bilateral cages.

Methods: A retrospective, multi-center, review of prospectively collected data was performed at 11 U.S. centers. The charts of 89 consecutive patients with cervical radiculopathy treated surgically at one level with PCF and cages were reviewed. Three cohorts of patients were included: standalone primary PCF with cages, circumferential surgery, and patients with post anterior cervical discectomy and fusion pseudarthrosis. Follow-up evaluation included clinical status and pain scale (VAS). Normal distribution of data was assessed by use of the Shapiro-Wilk test. The Wilcoxon test was used to test the differences for the data. The p level of 0.05 was considered significant.

Results: The mean follow-up interval was 7 months (range 62 weeks - 2 years). The overall post-surgery complication rate was 4.3%. There were two patients with neurological complications (C5 palsy, spinal cord irritation). Two patients had post-operative complications after discharge including one with atrial fibrillation and one with a parietal stroke. After accounting for relatedness to the PCF, the overall complication rate was 3.4%. The average (median) hospital stay for all three groups was 29 hours.

Conclusions: The results of our study show that posterior cervical fusion with cages can be considered a safe alternative for patients undergoing cervical spine surgery. The procedure has a favorable overall complication profile, short length of stay, and negligible blood loss.