Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery

Area of Science:

• Neurosurgery
• Spinal Surgery
• Patient Safety

Background:

• Iatrogenic spinal cord injury (SCI) is a severe complication of cervical spine surgery.
• Understanding the incidence and outcomes of SCI is critical for improving surgical safety.

Purpose of the Study:

• To determine the incidence of iatrogenic spinal cord injury (SCI) in patients undergoing elective cervical spine surgery.
• To analyze the characteristics and outcomes of patients who sustained SCI.

Main Methods:

• Retrospective multicenter case series involving 17,625 patients undergoing cervical spine surgery (C2-C7) from 2005-2011.
• Data were collected from 21 high-volume surgical centers within the AOSpine North America Clinical Research Network.
• Identification of iatrogenic SCI cases through medical record review.

Main Results:

• Three cases of iatrogenic SCI were identified, resulting in an overall incidence of 0.0% to 0.24% across institutions.
• Patients with SCI underwent various surgical procedures, including anterior-only, combined anterior-posterior, and posterior decompression/fusion.
• Neurologic recovery varied, with one patient experiencing complete recovery, one partial recovery, and one no motor function recovery.

Conclusions:

• Iatrogenic SCI following cervical spine surgery is a rare but serious adverse event.
• There is a lack of standardized protocols for the prevention, evaluation, and treatment of SCI.
• Recommendations include emergent imaging (MRI or CT myelography) and avoiding hypotension to manage potential SCI complications.