PMID- 33406919
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221029
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 12
IP  - 8
DP  - 2022 Oct
TI  - Respiratory Compromise After Anterior Cervical Spine Surgery: Incidence, 
      Subsequent Complications, and Independent Predictors.
PG  - 1647-1654
LID - 10.1177/2192568220984469 [doi]
AB  - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Respiratory compromise (RC) 
      is a rare but catastrophic complication of anterior cervical spine surgery (ACSS) 
      commonly due to compressive fluid collections or generalized soft tissue swelling 
      in the cervical spine. Established risk factors include operative duration, size 
      of surgical exposure, myelopathy, among others. The purpose of this current study 
      is to identify the incidence and clinical course of patients who develop RC, and 
      identify independent predictors of RC in patients undergoing ACSS for cervical 
      spondylosis. METHODS: A large, prospectively-collected registry was used to 
      identify patients undergoing ACSS for spondylosis. Patients with posterior 
      cervical procedures were excluded. Baseline patient characteristics were compared 
      using bivariate analysis, and multivariate analysis was employed to compare 
      postoperative complications and identify independent predictors of RC. RESULTS: 
      298 of 52,270 patients developed RC (incidence 0.57%). Patients who developed RC 
      had high rates of 30-day mortality (11.7%) and morbidity (75.8%), with unplanned 
      reoperation and pneumonia the most common. The most common reason for 
      reoperations were hematoma evacuation and tracheostomy. Independent 
      patient-specific factors predictive of RC included increasing patient age, male 
      gender, comorbidities such as chronic cardiac and respiratory disease, 
      preoperative myelopathy, prolonged operative duration, and 2-level ACCFs. 
      CONCLUSION: This is among the largest cohorts of patients to develop RC after 
      ACSS identified to-date and validates a range of independent predictors, many 
      previously only described in case reports. These results are useful for taking 
      preventive measures, identifying high risk patients for preoperative risk 
      stratification, and for surgical co-management discussions with the 
      anesthesiology team.
FAU - Boddapati, Venkat
AU  - Boddapati V
AUID- ORCID: 0000-0002-3333-2234
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Lee, Nathan J
AU  - Lee NJ
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Mathew, Justin
AU  - Mathew J
AUID- ORCID: 0000-0002-7699-780X
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Held, Michael B
AU  - Held MB
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Peterson, Joel R
AU  - Peterson JR
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Vulapalli, Meghana M
AU  - Vulapalli MM
AUID- ORCID: 0000-0003-1197-0400
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Lombardi, Joseph M
AU  - Lombardi JM
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Dyrszka, Marc D
AU  - Dyrszka MD
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Sardar, Zeeshan M
AU  - Sardar ZM
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Lehman, Ronald A
AU  - Lehman RA
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
FAU - Riew, K Daniel
AU  - Riew KD
AD  - The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA.
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
DEP - 20210107
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC9609542
OTO - NOTNLM
OT  - ACDF
OT  - cervical spine
OT  - complications
OT  - intubation
OT  - respiratory
COIS- The author(s) declared no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article.
EDAT- 2021/01/08 06:00
MHDA- 2021/01/08 06:01
PMCR- 2021/01/07
CRDT- 2021/01/07 05:40
PHST- 2021/01/08 06:00 [pubmed]
PHST- 2021/01/08 06:01 [medline]
PHST- 2021/01/07 05:40 [entrez]
PHST- 2021/01/07 00:00 [pmc-release]
AID - 10.1177_2192568220984469 [pii]
AID - 10.1177/2192568220984469 [doi]
PST - ppublish
SO  - Global Spine J. 2022 Oct;12(8):1647-1654. doi: 10.1177/2192568220984469. Epub 
      2021 Jan 7.