Resumo

GARCIA-ARMENGOL, R. et al. Anterior approach complications in cervical spine pathology. Neurocirugía [online]. 2007, vol.18, n.3, pp.209-220. ISSN 1130-1473.

Objective. To analyze cervical discectomy complications with anterior approach. Material and methods. Retrospectively clinical cases series of 193 patients, between December 1989 to December 2004, in the Hospital Germans Trias i Pujol in Badalona. We analyzed complications arisen with cervical anterior approach and its relation with differents procedures. Demographic variables (age, sex), clinical variables (onset symptoms, cervical pathology cause, complication type, and duration time) and surgical variables (operated levels number, procedure, graft used) were analyzed. We made a statistical analysis with multivariant analysis, T-Student test and Chi-square test to analyze the relation between the complicationsand different studied variables. Results. We found complications in 50 patients (25,91%). Most frequent has been dysphagia, present in 15 patients. Most of them appear with transitory form (13 patients) and in very few occasions permanent form (2 patients). T-Student test in statistical analysis showed no statistically significant differences (p=0,431) between the ages and complications, and were not statistically significant differences, used Chi-square test, in sex (p=0,515), in onset symptoms (p=0,923), in pathology origin (p=0,364), in a procedure(p=0,295), and graft used (p=0,382). We found statistically significant differences in operated levels number (p=0,018) with a ratio for the advantages (single /multiple) of 2,221. Multivariant analysis with linear regression model considering age, sex and operated levels number, showed that persistist the risk of complications in operated number levels, independently of the age or sex, being the multiple spaces a 117.3% more frequent than the single space (OR 2,173; IC95% 1,104-4,279). Conclusions. 1. Cervical anterior approach, is a simple technique, and safe surgically procedure with under number of complications. 2. Dysphagia is most frequent complication, but it is inherent to the procedure and it is solved without treatment in most ocasions. 3. Have been many the procedures used for the cervical spine fixation, with more than 40 years of experience, and still it is to define as he is the best one. It would be necessary more studies of prospective multicentric character to be able to compare clinical, radiological results, and the presence of complications.

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