Nasogastric tube in anterior cervical spine surgery, is it necessary?

The aim of this article was to verify the utility of nasogastric (NG) tube in primary anterior cervical surgeries. Palpating and identifying the NG tube introduced during induction is one of the ways of preventing esophageal injuries during surgery. It may also be used as a conduit for postoperative feeding. However, the use of NG tube is not without complications. Esophageal perforation is one of them, with an incidence of 0.3%.

A retrospective observational study was performed of patients who underwent a primary anterior cervical spine surgery from January 2007 to July 2017 by a single surgeon. The indications were degenerative, trauma, infection, and neoplasia. NG tube was avoided in all cases. The patients were followed for 6 months.

Our study included 356 patients (201 males and 155 females), with a mean age of 43.6 years (18-92 years) and a mean follow-up of 6 months. We had only one case of esophageal perforation (0.28%) attributed to a traumatic burst fracture.

This study indicates that the use of a NG tube in primary anterior cervical spine surgery can be avoided. Comprehensive knowledge of anatomy and meticulous dissection may avoid the disastrous complication of esophageal rupture. This way the discomfort and complications associated with NG tube can be avoided.