Skip to main content
Log in

Complications following anterior approaches to the cervical spine

Review of 535 surgical procedures

  • Original articles
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Summary

The authors present a retrospective study of 535 consecutive anterior approaches to the cervical spine back to 5 years. The data were analyzed for post-operative complications. This surgical procedure has been commonly used for more than 40 years, but the post-operative complications due to the anterior approach itself were presented with few accompanying statistics, with various and contradictory results. Injury to nearly all of the structures has been reported in the literature, the more frequent problems are hoarseness and dysphagia; other complications include perforation of the oesophagus, hematomas, vascular injury⋯

Analysis of this data allows to understand better the specific problems related to this surgical approach, and to suggest precautions at each stage of the course of exposure of cervical vertebrae.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Balmaseda MT, Pellioni DJ (1985) Oesophagocutaneous fistula in spinal cord injury. A complication of anterior cervical fusion. Arch Phys Med Rehabil 11: 783–784

    Google Scholar 

  2. Barber FA (1977) Anterior cervical fusion; the post-operative complications. Rochy Mt Med J 1: 93–100

    Google Scholar 

  3. Bertalanffy H, Eggert HR (1989) Complications of anterior cervical discectomy without fusion in 450 consecutive patients. Acta Neurochir 99: 41–50

    Google Scholar 

  4. Bulger RF, Rejowski JE, Beatty RA (1985) Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment. J Neurosurg 62: 657–661

    PubMed  Google Scholar 

  5. Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15: 602–614

    PubMed  Google Scholar 

  6. Cloward RB (1959) Vertebral body fusion for ruptured cervical disks. Description of instruments and operative technique. Am J Surg 98: 722–727

    PubMed  Google Scholar 

  7. Cloward RB (1971) Complications of anterior cervical disk operation and their treatment. Surgery 2: 175–182

    Google Scholar 

  8. Crampette L, Mondain M, Guerrier B, Fuentes JM, Segnarbieux F (1989) Le risque pharyngo-oesophagien de la chirurgie du rachis cervical par voie antérieure. Ann Otolaryngol 106: 491–495

    Google Scholar 

  9. Crandall PH, Barzdorf U (1966) Cervical spondytolic myelopathy. J Neurosurg 25: 57–66

    PubMed  Google Scholar 

  10. Dereymaeker A, Mulier J (1956) Nouvelle cure chirurgical de discopathies cervicales. La méniscectomie par voie ventrale suivie d'arthrodèse par greffe intercorporéale. Neurochirurgie 2: 233–234

    Google Scholar 

  11. Dingman RO, Grabb WC (1962) Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves. Plastic & Reconstr Surg 3: 266–272

    Google Scholar 

  12. Ebraheim NA, Lu J, Skie M, Heck BE, Yeasting RA (1997) Vulnerability of the recurrent laryngeal nerve in the anterior appraoch to the lower cervical spine. Spine 22: 2664–2667

    PubMed  Google Scholar 

  13. Ellis PDM, Pallister WK (1975) Recurrent laryngeal nerve palsy and endotracheal intubation. J Laryngol Otology 8: 823–826

    Google Scholar 

  14. Faaborg-Andersen K, Sonninen A (1960) The function of the extrinsic laryngeal muscles at different pitch. Acta Otolaryng 1-2: 89–93

    Google Scholar 

  15. Faaborg-Andersen K, Jensen A (1964) Unilateral paralysis of the suprior laryngeal nerve. Acta Otolaryng 57: 155–159

    PubMed  Google Scholar 

  16. Flynn TB (1982) Neurologic complications of anterior cervical interbody fusion. Spine 6: 536–539

    Google Scholar 

  17. Hankinson HL, Wilson CB (1975) Use of the operative microscope in anterior cervical discectomy without fusion. J Neurosurg 43: 452–456

    PubMed  Google Scholar 

  18. Heeneman H (1973) Vocal cord paralysis following the approaches to the anterior cervical spine. Laryngoscope 83: 17–21

    PubMed  Google Scholar 

  19. Hockauf H, Sailer R (1982) Post-operative recurrent nerve palsy. Head Neck Surgery 4: 380–384

    PubMed  Google Scholar 

  20. Jacobson L (1979) Bilateral vocal cord paralysis following anterior cervical fusion. Anaesthesia 34: 1020–1023

    PubMed  Google Scholar 

  21. Kaeser HE, Richter HR (1965) La paralysie isolée du muscle cricothyroïdien. Rev. Neurol. 112: 339–341

    PubMed  Google Scholar 

  22. Kuriloff DB, Blaugrund S, Ryan J, O'Leary P (1987) Delayed neck infection following anterior spine surgery. Laryngoscope 9: 1094–1098

    Google Scholar 

  23. Laccourreye H, Chabolle F, Brasnu D, Lacau St Guily J (1984) Les immobilités laryngées après intubation. Ann Otolaryng et Chir Cerv Faciale 4: 253–259

    Google Scholar 

  24. McAfee PC, Bohlman HH, Riley LH, Robinson RA, Southwick WO, Nachlas NE (1987) The anterior retropharyngeal approach to the upper part of the cervical spine. J Bone Joint Surg (A) 9: 1371–1383

    Google Scholar 

  25. Mounier-Kuhn P, Haguenauer JP (1976) Séquelles laryngées vocales des intubations de courte durée: incidences médico-légales. J Méd Lyon 57: 7–14

    Google Scholar 

  26. Murray JWG, Seymour RJ (1974) An anterior, extrapharyngeal, supra-hyoid approach to the first,second and third cervical vertebrae. Acta Orthop Scandin 45: 43–49

    Google Scholar 

  27. Nelson DW, Gingrass RP (1979) Anatomy of the mandibular branches of the facial nerves. Plastic & Reconstr Surg 4: 479–482

    Google Scholar 

  28. Nemiroff PM, Katz AD (1982) Extralaryngeal divisions of the recurrent laryngeal nerve. Surgical and clinical significance. Am J Surg 144: 466–469

    PubMed  Google Scholar 

  29. Netterville JL, Koriwchak MJ, Winkle M, Courey MS, Ossoff RH (1996) Vocal fold paralysis following the anterior approach to the cervical spine. Ann Otol Rhinol Laryngol 2: 85–91

    Google Scholar 

  30. Nobles ER (1970) Non recurrent laryngeal nerve. Arch Surg 100: 741–742

    PubMed  Google Scholar 

  31. Pansini A, Lore F (1972) Une nouvelle technique: la stomatotomie médiane longitudinale dans les myélopathies par discarthroses cervicales. Neurochirurgie 3: 189–202

    Google Scholar 

  32. Sanders G, Uyeda RY, Karlan MS (1983) Nonrecurrent inferior laryngeal nerves and their association with a recurrent branch. Am J Surg 146: 501–503

    PubMed  Google Scholar 

  33. Selecki BR (1971) Complications and limitations of anterior decompression and fusion of the cervical spine (Cloward's technique). Med J Australia 24: 1235–1237

    Google Scholar 

  34. Senegas J, Guerin J (1975) Technique de décompression médullaire antérieure dans les sténoses canalaires étendues. Rev Chir Orthop 61: 219–223

    PubMed  Google Scholar 

  35. Smith GW, Robinson RA (1958) The treatment of certain cervical spine disorders by anterior removal of the intervertebral disck and interbody fusion. J Bone Joint Surg (A) 3: 607–623

    Google Scholar 

  36. Tew J, Mayfield FH (1976) Complications of surgery of the anterior cervical spine. Clin Neurosurg 23: 424–434

    PubMed  Google Scholar 

  37. Thoreux P (1994) Complications neurologiques de la chirurgie du rachis de l'adulte. Conf Ens SOFCOT, cahier 48: 183–195

    Google Scholar 

  38. Welsh LW, Welsh JJ, Chinnici JC (1987) Dysphagia due to cervical spine surgery. Ann Otol Rhinol Laryngol 1: 112–115

    Google Scholar 

  39. Whitecloud TS (1978) Complications of anterior cervical fusion. A.A.O.S., Instructional courses lectures. Vol 27, Chap 16

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Viejo-Fuertes, D., Liguoro, D., Ansari, M. et al. Complications following anterior approaches to the cervical spine. Eur J Orthop Surg Traumatol 10, 177–181 (2000). https://doi.org/10.1007/BF01682311

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01682311

Key words

Navigation