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Global Spine J. 2017 Apr;7(1 Suppl):96S-102S. doi: 10.1177/2192568216687753. Epub 2017 Apr 1.

Prevalence and Outcomes in Patients Undergoing Reintubation After Anterior Cervical Spine Surgery: Results From the AOSpine North America Multicenter Study on 8887 Patients.

Author information

1
Toronto Western Hospital, Toronto, Ontario, Canada.
2
Keio University, Tokyo, Japan.
3
Nagoya University, Nagoya, Japan.
4
Norton Leatherman Spine Center, Louisville, KY, USA.
5
Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
6
Boston University Medical Center, Boston, MA, USA.
7
Rush University Medical Center, Chicago, IL, USA.
8
Kansas University Medical Center, Kansas City, KS, USA.
9
Cleveland Clinic, Cleveland, OH, USA.
10
Brown University, Providence, RI, USA.
11
Rhode Island Hospital, Providence, RI, USA.
12
The Miriam Hospital, Providence, RI, USA.
13
Norman Prince Neurosciences Institute, Providence, RI, USA.
14
Mayo Clinic, Rochester, MN, USA.
15
Boston University, Boston, MA, USA.
16
University of Toronto, Toronto, Ontario, Canada.
17
Columbia University, New York, NY, USA.
18
NewYork-Presbyterian/The Allen Hospital, New York, NY, USA.

Abstract

STUDY DESIGN:

A multicenter, retrospective cohort study.

OBJECTIVE:

To evaluate clinical outcomes in patients with reintubation after anterior cervical spine surgery.

METHODS:

A total of 8887 patients undergoing anterior cervical spine surgery were enrolled in the AOSpine North America Rare Complications of Cervical Spine Surgery study. Patients with or without complications after surgery were included. Demographic and surgical information were collected for patients with reintubation. Patients were evaluated using a variety of assessment tools, including the modified Japanese Orthopedic Association scale, Nurick score, Neck Disability Index, and Short Form-36 Health Survey.

RESULTS:

Nine cases of postoperative reintubation were identified. The total prevalence of this complication was 0.10% and ranged from 0% to 0.59% across participating institutions. The time to development of airway symptoms after surgery was within 24 hours in 6 patients and between 5 and 7 days in 3 patients. Although 8 patients recovered, 1 patient died. At final follow-up, patients with reintubation did not exhibit significant and meaningful improvements in pain, functional status, or quality of life.

CONCLUSIONS:

Although the prevalence of reintubation was very low, this complication was associated with adverse clinical outcomes. Clinicians should identify their high-risk patients and carefully observe them for up to 2 weeks after surgery.

KEYWORDS:

anterior cervical surgery; clinical outcomes; hematoma/edema evacuation; multicenter study; rare complications; reintubation

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: Narihito Nagoshi reports grants from AOSpine North America during the conduct of the study; Michael G. Fehlings reports grants from AOSpine North America during the conduct of the study; Hiroaki Nakashima reports grants from AOSpine North America during the conduct of the study; Lindsay Tetreault reports grants from AOSpine North America during the conduct of the study; Jeffrey L. Gum reports grants from AOSpine North America during the conduct of the study, personal fees from Medtronic, Alphatec, Stryker, LifeSpine, Acuity, Pacira, PAKmed, Gerson Lehrman Group, personal fees from OREF, AOSpine, personal fees from Acuity, other from Medtronic, personal fees from MiMedx, Pacira Pharmaceuticals, Alphatec, grants from Fischer Owen Fund, nonfinancial support from American Journal of Orthopaedics, nonfinancial support from American Journal of Orthopaedics, The Spine Journal, outside the submitted work; Zachary A. Smith reports grants from AOSpine North America during the conduct of the study; Wellington K. Hsu reports grants from AOSpine North America during the conduct of the study, personal fees from Medtronic, personal fees from Stryker, personal fees from Bacterin, personal fees from Graftys, personal fees from Ceramtec, personal fees from Relievant, personal fees from Bioventus, personal fees from Globus, personal fees from SpineSmith, outside the submitted work; Chadi A. Tannoury reports grants from AOSpine North America during the conduct of the study; Tony Tannoury reports grants from AOSpine North America during the conduct of the study; Vincent C. Traynelis reports grants from AOSpine North America during the conduct of the study, grants from National Institutes of Health, outside the submitted work, and Consultant for Medtronic Royalties from Medtronic Institutional Fellowship Support from Globus; Thomas E. Mroz reports other from AOSpine, during the conduct of the study, personal fees from Stryker, personal fees from Ceramtec, other from Pearl Diver, outside the submitted work; Ziya L. Gokaslan reports grants from AOSpine North America during the conduct of the study, grants from AOSpine North America, personal fees from AO Foundation, grants from AOSpine, outside the submitted work; Mohamad Bydon reports grants from AOSpine North America during the conduct of the study; Bruce C. Jobse reports grants from AOSpine North America during the conduct of the study; Eric M. Massicotte reports grants from AOSpine North America during the conduct of the study, grants from Medtronic, Depuy-Synthes Spine Canada, personal fees from Watermark consulting, grants from AOSpine North America, nonfinancial support from AOSpine North America, outside the submitted work; and 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; Paul M. 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; Anthony F. De Giacomo reports grants from AOSpine North America during the conduct of the study.

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