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Global Spine J. 2017 Apr;7(1 Suppl):127S-131S. doi: 10.1177/2192568217694005. Epub 2017 Apr 1.

Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study.

Author information

1
USC Spine Center, Los Angeles, CA, USA.
2
University of Southern California, Los Angeles, CA, USA.
3
UCLA Spine Center, Santa Monica, CA, USA.
4
University of California Los Angeles, Santa Monica, CA, USA.
5
Kansas University Medical Center, Kansas City, KS, USA.
6
Toronto Western Hospital, Toronto, Ontario, Canada.
7
Cleveland Clinic, Cleveland, OH, USA.
8
Columbia University, New York, NY, USA.
9
New York-Presbyterian/The Allen Hospital, New York, NY, USA.

Abstract

STUDY DESIGN:

A retrospective multicenter study.

OBJECTIVE:

Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery.

METHODS:

Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death.

RESULTS:

A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There was no case of intraoperative death.

CONCLUSIONS:

Death during cervical spine surgery is a very rare complication. In our multicenter study, there was a 0% mortality rate. Using an adequate surgical approach for patient diagnosis and comorbidities may be the reason how the occurrence of this catastrophic adverse event was prevented in our patient population.

KEYWORDS:

cervical spine; complications; death; multicenter; surgery

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Jeffrey C. Wang reports royalties (Aesculap, Biomet, Amedica, Seaspine, Synthes), stock ownership (Fziomed), private investments (Promethean Spine, Paradigm spine, Benevenue, NexGen, Vertiflex, electrocore, surgitech, corespine, expanding orthopaedics, osprey, bone biologics, curative biosciences, pearldiver), Board of Directors (North American Spine Society [nonfinancial, reimbursement for travel for board meetings, courses, etc.], North American Spine Foundation [nonfinancial], Cervical Spine Research Society [nonfinancial, reimbursement for travel for board meetings], AOSpine/AO Foundation [honorariums for board position], fellowship support (AO Foundation [spine fellowship funding paid to institution]; Zorica Buser reports Xenco Medical (consultancy), AOSpine (consultancy, past) Zorica Buser reports grants from AOSpine North America during the conduct of the study; David Fish reports grants from AOSpine North America during the conduct of the study; Elizabeth L. Lord reports grants from AOSpine North America during the conduct of the study; Allison Roe reports grants from AOSpine North America during the conduct of the study; Dhananjay Chatterjee reports grants from AOSpine North America during the conduct of the study; Erica Gee reports grants from AOSpine North America during the conduct of the study; Erik Mayer reports grants from AOSpine North America, during the conduct of the study; Marisa Yanez reports grants from AOSpine North America during the conduct of the study; Owen McBride reports grants from AOSpine North America during the conduct of the study; Peter Cha reports grants from AOSpine North America during the conduct of the study; Paul Arnold reports grants from AOSpine North America during the conduct of the study; other from Z-Plasty, other from Medtronic Sofamore Danek, other from Stryker Spine, other from FzioMed, other from AOSpine North America, other from Life Spine, other from Integra Life, other from Spine Wave, other from MIEMS, other from Cerapedics, other from AOSpine North America, outside the submitted work; Michael G. Fehlings reports grants from AOSpine North America during the conduct of the study; Thomas E. Mroz reports other from AO Spine, grants from AOSpine North America during the conduct of the study; personal fees from Stryker, personal fees from Ceramtec, other from Pearl Diver, outside the submitted work; K. Daniel Riew reports personal fees from AOSpine International, other from Global Spine Journal, other from Spine Journal, other from Neurosurgery, personal fees from Multiple Entities for defense, plantiff, grants from AOSpine, grants from Cerapedics, grants from Medtronic, personal fees from AOSpine, personal fees from NASS, personal fees from Biomet, personal fees from Medtronic, nonfinancial support from Broadwater, outside the submitted work.

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