Delayed screw migration following anterior cervical discectomy and fusion.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2024-12-06 DOI:10.1016/j.wneu.2024.12.014

Matthew T Carr, Jeremy Steinberger, John K Houten

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引用次数: 0

Abstract

Objective: To identify the clinical and surgical characteristics and treatment options of patients suffering delayed (> 1 month) screw back-out after anterior cervical discectomy and fusion (ACDF).

Methods: A systematic review was performed searching Embase, Medline, and Scopus for relevant case studies and case series of delayed screw back-out after ACDF.

Results: 25 studies encompassing 31 patients were identified and included. Average time to screw back-out was 4.6 years. 52% of patients presented with dysphagia, and 61% had a pharyngoesophageal injury. 5 patients were asymptomatic. 25 patients underwent surgery to remove hardware, 12 patients had surgical repair of the esophagus or hypopharynx, and 4 patients were managed conservatively. Antibiotic duration when given ranged from 2 weeks to 6 months. NPO duration ranged from 4 days to 3 months.

Conclusions: The risk of screw back-out is low, but it can be a devastating complication. The majority of reported cases developed pharyngoesophageal injury and dysphagia. Surgery is often required to remove the hardware and repair any damage to the esophagus or hypopharynx, and may require prolonged antibiotics and NPO. Rarely, patients may be asymptomatic and treated conservatively; but in 7 patients in this series in whom back-out was initially managed conservatively there worsening back-out or injury that occurred an average of 29 months later.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS