Here are five patterns and points on cervical spine surgery.
1. Complications more frequent in trauma and spinal oncologic procedures. According to a study published in The Journal of Spinal Disorders & Techniques, complications are more frequent in cervical spine surgery among trauma and spinal oncologic patients. The study also found that incidence of early complications in cervical spine procedures is greater than was previously suspected. This difference most likely stems from the use of a broad definition for perioperative complications, elimination of recall bias through use of prospective assessment and an overall increase complexity in the cases. Of the 121 patients participating in the study, complications were found in 47.1 percent. Of the incidences of complications, 40.5 percent were of minor and 18.2 percent were of major complications. Twenty percent of the major complications were in cases of infection and 30 percent in spinal oncologic procedures.
2. Medical liability data associated with cervical spine surgery. Sharing data regarding the morbidity associated with cervical spine surgery can lessen patients' expectations and limit the spine surgeon's liability, according to a study published in Spine. Researchers questioned 68 patients involved in medical liability lawsuits for cervical spine surgery, 41 of which experienced postoperative neurologic deficits, including quadriplegia. Malpractice suits involved 63 spine surgeons and the most common malpractice events prompting the suits were negligent surgery, lack of informed consent and failure to diagnose or treat the condition. The outcomes for the suits included 30 defense verdicts, 22 plaintiffs' verdicts with an average payout of $4 million and 26 settlements with an average payout of $2.4 million.
3. Endoscopic cervical discectomy. If patients with herniated discs don't respond to conservative treatment, such as physical therapy and pain-relieving drugs after eight to 12 weeks, undergoing an endoscopic cervical discectomy can be an option, according to a release from Atlantic Spinal Care. The endoscopic cervical discectomy involves inserting a four-millimeter metal tube into the spine through a small incision. A camera is inserted through the tube to view the damaged disc without completely opening the surgical site. After assessing the damaged disc, the surgeon can decide either to pull a large piece out with a grasper or vaporize a small bulge with a laser. In many cases, the surgery is performed as an outpatient procedure. Surgeons who would like to incorporate endoscopic cervical spine surgery into their practice often undergo extensive training with the endoscope and complete cadaver courses and mentorships. They often become skilled in endoscopic lumbar surgery before learning the cervical procedure.
4. Anterior cervical discectomies using PEEK cages. Cervical spondylosis patients can be treated successfully with anterior cervical discectomy and fusion using PEEK cages, according to a study published in The Journal of Spinal Disorders & Techniques. A retrospective analysis was taken for 39 patients who were diagnosed with cervical spondylosis and underwent an anterior cervical discectomy using PEEK cages. The sympathetic symptoms improved in all patients. One patient experienced cerebral spinal fluid leakage but recovered one week after surgery. Two patients felt mild swelling and discomfort.
5. Rigid construct better than non-rigid for occipitocervical fusion. Researchers examined the data from 71 occipitocervical fusion patients — 25 with non-rigid technique and 46 with rigid construct, according to a study published in The Journal of Spinal Disorders & Techniques. The average follow up was 6.3 months. A 48 percent complication rate was reported for the 25 non-rigidly fused patients while a 10 percent complication rate was reported for the 46 rigidly fused patients.
Read other coverage on cervical spine surgery:
- 6 Things to Know About Endoscopic Cervical Spine Surgery
1. Complications more frequent in trauma and spinal oncologic procedures. According to a study published in The Journal of Spinal Disorders & Techniques, complications are more frequent in cervical spine surgery among trauma and spinal oncologic patients. The study also found that incidence of early complications in cervical spine procedures is greater than was previously suspected. This difference most likely stems from the use of a broad definition for perioperative complications, elimination of recall bias through use of prospective assessment and an overall increase complexity in the cases. Of the 121 patients participating in the study, complications were found in 47.1 percent. Of the incidences of complications, 40.5 percent were of minor and 18.2 percent were of major complications. Twenty percent of the major complications were in cases of infection and 30 percent in spinal oncologic procedures.
2. Medical liability data associated with cervical spine surgery. Sharing data regarding the morbidity associated with cervical spine surgery can lessen patients' expectations and limit the spine surgeon's liability, according to a study published in Spine. Researchers questioned 68 patients involved in medical liability lawsuits for cervical spine surgery, 41 of which experienced postoperative neurologic deficits, including quadriplegia. Malpractice suits involved 63 spine surgeons and the most common malpractice events prompting the suits were negligent surgery, lack of informed consent and failure to diagnose or treat the condition. The outcomes for the suits included 30 defense verdicts, 22 plaintiffs' verdicts with an average payout of $4 million and 26 settlements with an average payout of $2.4 million.
3. Endoscopic cervical discectomy. If patients with herniated discs don't respond to conservative treatment, such as physical therapy and pain-relieving drugs after eight to 12 weeks, undergoing an endoscopic cervical discectomy can be an option, according to a release from Atlantic Spinal Care. The endoscopic cervical discectomy involves inserting a four-millimeter metal tube into the spine through a small incision. A camera is inserted through the tube to view the damaged disc without completely opening the surgical site. After assessing the damaged disc, the surgeon can decide either to pull a large piece out with a grasper or vaporize a small bulge with a laser. In many cases, the surgery is performed as an outpatient procedure. Surgeons who would like to incorporate endoscopic cervical spine surgery into their practice often undergo extensive training with the endoscope and complete cadaver courses and mentorships. They often become skilled in endoscopic lumbar surgery before learning the cervical procedure.
4. Anterior cervical discectomies using PEEK cages. Cervical spondylosis patients can be treated successfully with anterior cervical discectomy and fusion using PEEK cages, according to a study published in The Journal of Spinal Disorders & Techniques. A retrospective analysis was taken for 39 patients who were diagnosed with cervical spondylosis and underwent an anterior cervical discectomy using PEEK cages. The sympathetic symptoms improved in all patients. One patient experienced cerebral spinal fluid leakage but recovered one week after surgery. Two patients felt mild swelling and discomfort.
5. Rigid construct better than non-rigid for occipitocervical fusion. Researchers examined the data from 71 occipitocervical fusion patients — 25 with non-rigid technique and 46 with rigid construct, according to a study published in The Journal of Spinal Disorders & Techniques. The average follow up was 6.3 months. A 48 percent complication rate was reported for the 25 non-rigidly fused patients while a 10 percent complication rate was reported for the 46 rigidly fused patients.
Read other coverage on cervical spine surgery:
- 6 Things to Know About Endoscopic Cervical Spine Surgery