Revision surgery in cervical spine

Luca Papavero, Paolo Lepori, Gregor Schmeiser

Research output: Contribution to journalArticle

Abstract

Purpose: To report the indications, presurgical planning, operative techniques, complications for making decisions in cervical revision surgery (CRS). Methods: Hundred and two patients underwent CRS over a four-year period. Epidemiological data, the type of first surgery, CRS surgical techniques and complications were retrospectively evaluated. Pain and neurological symptoms were assessed according to the validated Odom criteria. CRS indications were classified into five categories: adjacent segment disease (ASD), infection (INF), implant failure–pseudarthrosis (IFP), non-infectious complication, and deformity. Patients were classified into three groups, according to the approach of the index procedure: anterior, posterior, or 360°. Results: The mean patient age was 63 years (59% males). ASD (40%), INF (23%), and IFP (22%) were observed in 85% of patients. CRS was performed with the same approach that was used in the index procedure in 64% of the anterior group and in 83% of the posterior group. In the 360° group, 64% of CRSs was performed with a posterior access. The early complication rate was 4.9%. The outcome was excellent in 19 patients (19%), good in 37 patients (36%), satisfactory in 27 patients (26%), and poor in six patients (6%). Thirteen patients (13%) were lost to follow-up. No implants failed radiologically or required surgical revision. Conclusions: CRS required painstaking planning and mastery of a variety of surgical techniques. The results were rewarding in half and satisfactory in a quarter of the patients. The complication rate was lower than expected. In the most complex cases, referral to a specialized center is recommended. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

Original languageEnglish
JournalEuropean Spine Journal
DOIs
Publication statusAccepted/In press - Jan 1 2020
Externally publishedYes

Keywords

  • Cervical anterior surgery
  • Cervical revision surgery
  • Complications cervical surgery
  • Implant failure cervical surgery
  • Malalignment cervical spine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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  • Cite this

    Papavero, L., Lepori, P., & Schmeiser, G. (Accepted/In press). Revision surgery in cervical spine. European Spine Journal. https://doi.org/10.1007/s00586-019-06281-x