Revision surgery for failed cervical spine reconstruction: review article

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Spinal Surgery

Background:

• Increasing rates of cervical spine procedures necessitate understanding revision surgery causes.
• Surgeons require knowledge of post-surgical changes and a treatment algorithm for complex cases.

Purpose of the Study:

• To review revision cervical spine surgery rates and etiology.
• To describe a treatment algorithm for evaluating these complex patients.

Main Methods:

• Conducted a narrative and literature review.
• Performed a MEDLINE (PubMed) search yielding 353 articles (1993-2014).
• Analyzed abstracts and reviewed 32 relevant articles.

Main Results:

• Revision rates vary based on procedure type and extent.
• Patient evaluation involves history, indication review, lab work (infection), and imaging (CT for pseudarthrosis, MRI for soft tissues/infection differentiation).
• Correction of sagittal alignment is crucial.

Conclusions:

• Revision surgery can effectively treat recurrent or new symptoms after cervical spine reconstruction.
• Identifying the etiology and completing appropriate workup are essential for successful revision surgery.