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Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery.

TitleIatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery.
Publication TypeJournal Article
Year of Publication2017
AuthorsDaniels AH, Hart RA, Hilibrand AS, Fish DE, Wang JC, Lord EL, Buser Z, P Tortolani J, D Stroh A, Nassr A, Currier BL, Sebastian AS, Arnold PM, Fehlings MG, Mroz TE, K Riew D
JournalGlobal Spine J
Volume7
Issue1 Suppl
Pagination84S-90S
Date Published2017 Apr
ISSN2192-5682
Abstract

STUDY DESIGN: Retrospective cohort study of prospectively collected data.

OBJECTIVE: To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury.

RESULTS: In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged from 0.0% to 0.24%. Of the 3 patients with quadriplegia, one underwent anterior-only surgery with 2-level cervical corpectomy, one underwent anterior surgery with corpectomy in addition to posterior surgery, and one underwent posterior decompression and fusion surgery alone. One patient had complete neurologic recovery, one partially recovered, and one did not recover motor function.

CONCLUSION: Iatrogenic spinal cord injury following cervical spine surgery is a rare and devastating adverse event. No standard protocol exists that can guarantee prevention of this complication, and there is a lack of consensus regarding evaluation and treatment when it does occur. Emergent imaging with magnetic resonance imaging or computed tomography myelography to evaluate for compressive etiology or malpositioned instrumentation and avoidance of hypotension should be performed in cases of intraoperative and postoperative spinal cord injury.

DOI10.1177/2192568216688188
Alternate JournalGlobal Spine J
PubMed ID28451499
PubMed Central IDPMC5400194