Optimizing Wound Healing Following Cervical Spine Surgery.

Abstract

Introduction: The volume of cervical spine procedures continues to grow. Plastic and reconstructive surgeons (PRSs) commonly address complex wound-related issues in such cases. The present study investigates whether routine PRS closure of cervical spinal wounds improves outcomes compared with those performed without.

Methods: Data of patients operated on for cervical spine procedures by the senior author (P.J.T.) between January 2016 and June 2023 were analyzed. Only posterior surgical approaches were included. Demographics, medical status, procedure indication, and surgical characteristics were reviewed. Wound-related and medical complications were examined within a 30-day postoperative period, along with incidences of unplanned reoperation or readmission. Outcomes were compared with 12,943 CPT-matched cases reported by the American College of Surgeons National Surgical Quality Improvement Program.

Results: Five hundred eighty-eight cases were included: 511 (87%) were performed for degenerative spine conditions, 60 (10%) for traumatic injuries, 7 (1%) for neoplasms, 7 (1%) for congenital conditions, and 3 (0.5%) for infected cyst management. The PRS group demonstrated a greater prevalence of diabetes (27% vs 22%, P = 0.016) and chronic obstructive pulmonary disease (10% vs 6%, P < 0.001). Those who received PRS closure were less likely to return to the operating room (1% vs 3%, P = 0.005) or experience a wound-related readmission (2% vs 5%, P < 0.001).

Conclusion: PRS closure of cervical spine cases minimizes the risk of reoperation and readmission, even among a population with comorbidities known to be associated with wound-related complications. Improved outcomes were especially observed for more complex wounds requiring local flap closure. Thus, there is strong evidence to support PRS involvement in cervical spine surgery.