PMID- 33194289
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220418
IS  - 2229-5097 (Print)
IS  - 2152-7806 (Electronic)
IS  - 2152-7806 (Linking)
VI  - 11
DP  - 2020
TI  - Frequency, recognition, and management of postoperative hematomas following 
      anterior cervical spine surgery: A review.
PG  - 356
LID - 10.25259/SNI_669_2020 [doi]
LID - 356
AB  - BACKGROUND: We reviewed the frequency, recognition, and management of 
      postoperative hematomas (HT) (i.e. retropharyngeal [RFH], wound [WH], and/or 
      spinal epidural hematomas [SEH]) following anterior cervical discectomy/fusion 
      (ACDF), anterior corpectomy fusion (ACF), and/or anterior cervical spine surgery 
      (ACSS). METHODS: Postoperative cervical hematomas following ACDF, ACF, and ACSS 
      ranged from 0.4% to 1.2% in a series of 11 studies involving a total of 44, 030 
      patients. These included; 4 single case reports, 2 small case series (6 and 30 
      cases), 4 larger series (758-2375 for a total of 6729 patients), an a large 
      NSQUIP (National Surgical Quality Improvement Program ) Database involving 37,261 
      ACDF patients. RESULTS: Risk factors contributing to postoperative cervical 
      hematomas included; DISH (diffuse idiopathic skeletal hyperostosis), ossification 
      of the posterior longitudinal ligament (OPLL), therpeutic heparin levels, longer 
      operative times, multilevel surgery, ASA Scores of +/= 3, (American Society of 
      Anesthesiologists), prone surgery, operative times > 4 hours, smoking, 
      higher/lower body mass index (BMI), anemia, age >65, > medical comorbidities, and 
      male gender. Notably, the use of drains did not prevent HT, and did not increase 
      the infection, or reoperation rates. CONCLUSION: In our review of 11 studies 
      focused on anterior cervical surgery, the incidence of postoperative hematomas 
      ranged from 0.4 to 1.2%. Early recognition of these postoperative hemorrhages, 
      and appropriate management (surgical/non-surgical) are critical to optimize 
      recovery, and limit morbidity, and mortality.
CI  - Copyright: (c) 2020 Surgical Neurology International.
FAU - Epstein, Nancy
AU  - Epstein N
AD  - Clinical Professor of Neurological Surgery, School of Medicine, State University 
      of NY at Stony Brook, New York, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201021
PL  - United States
TA  - Surg Neurol Int
JT  - Surgical neurology international
JID - 101535836
PMC - PMC7656048
OTO - NOTNLM
OT  - Anterior diskectomy/fusion
OT  - Out-patient surgery
OT  - Postoperative wound hematoma
OT  - Retropharyngeal hematoma
OT  - Risk factors
OT  - Selection criteria
OT  - Symptomatic epidural hematoma
COIS- There are no conflicts of interest.
EDAT- 2020/11/17 06:00
MHDA- 2020/11/17 06:01
PMCR- 2020/10/21
CRDT- 2020/11/16 08:51
PHST- 2020/09/23 00:00 [received]
PHST- 2020/09/23 00:00 [accepted]
PHST- 2020/11/16 08:51 [entrez]
PHST- 2020/11/17 06:00 [pubmed]
PHST- 2020/11/17 06:01 [medline]
PHST- 2020/10/21 00:00 [pmc-release]
AID - SNI-11-356 [pii]
AID - 10.25259/SNI_669_2020 [doi]
PST - epublish
SO  - Surg Neurol Int. 2020 Oct 21;11:356. doi: 10.25259/SNI_669_2020. eCollection 
      2020.