Factors Affecting Outcomes in Anterior Cervical Spine Surgery

Area of Science:

• Spine Surgery
• Surgical Outcomes
• Patient Safety

Background:

• Anterior cervical spine surgery (ACSS) is a common procedure, but perioperative complications can impact patient outcomes.
• Identifying factors influencing these complications is crucial for improving surgical care.

Purpose of the Study:

• To evaluate procedure-related complications following ACSS.
• To identify key factors that increase or decrease the risk of perioperative complications.

Main Methods:

• A retrospective cohort study of 3401 patients undergoing ACSS between January 2015 and August 2023.
• Analysis included patient, procedure, surgeon, and institutional factors using univariable and multivariable logistic regression.
• Outcomes were categorized into objective and subjective perioperative complications.

Main Results:

• The objective complication rate was 4.44%, and subjective complications occurred at 6.70%.
• High-volume surgeons (≥15 cases/year) and otolaryngologist involvement in revision surgeries were associated with decreased objective complications.
• Advanced age and multi-level (≥3) spinal surgeries increased subjective complications, while otolaryngologist involvement in upper cervical cases decreased them.

Conclusions:

• A multidisciplinary approach, particularly involving otolaryngologists as co-surgeons in complex ACSS cases, may improve surgical outcomes.
• Increasing surgeon case volume and strategic otolaryngologist collaboration can potentially reduce complication rates and enhance the quality of care.