Complications of the anterior cervical approach in spine surgery

Abstract

The anterior cervical approach is a time-tested, minimally invasive procedure that is leveraged for some of the most common spine surgeries performed in the world. The use of natural muscle planes, specialized retractors, and meticulous attention to surrounding structures have enabled surgeons to treat patients with a variety of pathologies. Although associated with high success rates, recurring complications have been described. The goal of this literature review is to detail pertinent complications seen in such surgeries. Here we describe the incidence rates, risk factors, prevention, and treatment for commonly cited anterior cervical complications. These include dysphagia, esophageal perforation, C5 nerve palsy, recurrent laryngeal nerve injury, Horner's syndrome, hematoma, vascular injury, and infection. Our review suggests that while morbidity rates for these procedures are low, awareness of risk factors and preventative measures can further reduce such complications.