SURGICAL COMPLICATIONS AFTER ANTERIOR CERVICAL CORPECTOMY WITH CAGE FIXATION FOR CERVICAL SPONDYLOTIC MYELOPATHY

Abstract

BACKGROUND: Cervicalspondylosis is one of the most commonand disabling neural pathology in the spine and can considerably decrease quality of life .Surgical intervention is advised in those patients of Cervicalspondylosis, who did not respond to medical therapy and/or have progressive neurological symptoms . There is a lot of debate in the surgical management of the cervical spondylotic myelopathy(CSM)in the literature, but the best surgical management remains controversial. This study was conducted to know the surgical complications after anterior cervical corpectomy with cage fixation for cervical spondylotic myelopathy. 
METHODS: :We analyzed the record of 36 patients who underwent anterior cervical corpectomy with cage fixation for cervicalspondyloticmyelopathy in Neurosurgery“A” Departmentof Lady Reading Hospital from January 2014 to January 2016.Patientswith congenital cervical stenosis, primary posterior pathology, not fit and not willing for surgery were excluded from the study. Patient were followed-up for six months. The demographic data,clinical,radiological and post-operative surgical complicationsof the patients were analyzedto assess the surgical complications.
RESULTS: Out of 36 patients,24 (66.6%) were male, age ranged from 3572 years.Major clinical features were hypoesthesia(n=29, 80.5%), limbs weakness(n=21, 58.3%), gait ataxia(n=21, 58.3%), dysesthesia (n=20, 55.55%) and neck pain(n=16, 44.44%). The surgical complications included;implantscrew displacement (n=3,8.3%) and implant dislodgement (n=1, 2.8%), transient recurrent laryngeal nerve injury(n=3, 8.3%), infection (n=2, 5.5%),transient dysphagia (n=2, 5.5%), prevertebral hematoma(n=2, 5.5%)and esophageal fistula(n=1, 2.8%)were observed.
CONCLUSION:Anterior cervical corpectomy with cage fixation for cervical myelopathy less than 3 levels is beneficial to the patients if operated in expert hands in early course of disease in terms of lesser permanent neurological deficits. 
KEY WORDS: Anterior Cervical Corpectomy, Cervical Spondyloticmyelopathy, Congenital Cervical Stenosis.