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Utility of Routine Outpatient Cervical Spine Imaging Following Anterior Cervical Corpectomy and Fusion
Atman Desai1, Arjun V Pendharkar1, Jessica G Swienckowski2
1Department of Neurosurgery, Stanford University School of Medicine.
Cureus
|January 1, 2016
Summary
Routine imaging after anterior cervical corpectomy and fusion (ACCF) rarely changes management, even when abnormalities are found. This suggests limited utility for routine postoperative imaging in ACCF patients, especially for multi-level fusions.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Fusion Techniques
Background:
- Anterior cervical corpectomy and fusion (ACCF) can lead to construct failure, a rare complication.
- Routine postoperative imaging is common but its utility is not well-established.
Purpose of the Study:
- To evaluate the clinical utility of routine postoperative imaging following ACCF.
- To determine if routine imaging impacts patient management or outcomes.
Main Methods:
- Retrospective review of 65 patients undergoing ACCF between 2004-2009.
- Analysis of routine perioperative and follow-up cervical spine radiographs up to two years post-surgery.
Main Results:
- Six unexpected findings were noted in 57 patients with early follow-up imaging.
- Only one patient required repeat surgery for asymptomatic recurrent kyphosis; another had abnormal imaging without intervention.
- Routine imaging did not alter management in 43 single-level ACCF cases.
Conclusions:
- Routine imaging after ACCF can detect asymptomatic instrument failure.
- The clinical significance and impact on management of incidental findings are limited, especially in single-level fusions.
- A potential limited role for routine postoperative imaging in ACCF is suggested.
