Abstract
ABSTRACT Objective: To determine the correlation between morbidity/mortality and the pre-surgical protocol in patients undergoing anterior cervical surgical approach. Methods: Retrospective, cross-sectional and descriptive study, in which 114 patients who underwent anterior cervical surgical approach were reviewed, divided into two groups: “Group A” Conventional Presurgical Protocol (CPP) and “Group B” Extended Presurgical Protocol (EPP). Statistical analysis used the IBM SPSS Statistics Base v.24 software. Results: We evaluated 114 patients, 35 from “Group A”, 79 from “Group B”, 83 (72.8%) with cervical myelopathy, 30 (26.3%) with cervicobrachialgia. “Group A” had 10 cases of respiratory failure, with 5 secondary to bronchial secretion, 2 secondary to cervical hematoma. “Group B” had 12 cases of respiratory failure, 3 secondary to bronchial secretion and 1 secondary to cervical hematoma. Conclusions: The extended presurgical protocol can be the answer to reduce complications by improving selection parameters of the candidate patient for a surgical procedure of the cervical spine. Level of Evidence III; Case-control studyg.
Highlights
Degenerative pathology of the cervical disc in its different phases can affect nerve structures, such as roots and the spinal cord, causing deficit and pain with serious impact to the quality of life
Thirty-five (30.7%) of them belonged to Group A (CPP), with 26 men and 9 women, and the remaining 79 (69.2%) belonged to Group B (EPP), with 39 men and 40 women
Among the patients in Group A (n=35), 10 cases of respiratory failure were reported with a rate of 28.5% of the group and 8.7% of the total sample, five of which were secondary to bronchial secretion (14.2%), two secondary to cervical hematoma (5.7%), two to respiratory tract infection (5.7%), and one with edema of the upper airways (2.8%)
Summary
Degenerative pathology of the cervical disc in its different phases can affect nerve structures, such as roots and the spinal cord, causing deficit and pain with serious impact to the quality of life. Acute serious complications are rare but, when they occur, they can be potentially mortal and present in during the time between the surgical event and the immediate postoperative period These complications are all those that may restrict and compromise the airways, hindering breathing, such as edema of the glottis and larynx, paralysis of the glottis, lesion of the vertebral artery, spinal edema, neck hematoma, premature failure of the instrumentation and/or fixation system, as well as a delay in extubation, among others. Obstruction of the airways following anterior cervical spine surgery caused by retropharyngeal hematoma or edema of the soft tissues has an incidence of from 1 to 6% globally This can occur within minutes or up to 10 days following the surgery, but is more frequent within the first 24 to 48 hours after the surgical procedure.[2]
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