![]() ![]() MRI, magnetic resonance imaging CT, computed tomography OPLL, ossification of the posterior longitudinal ligament OYL, ossification of the yellow ligament. Spine surgeons should be aware of these complications associated with PCF and the corresponding prevention strategies optimize patient outcomes.įigure 1 Pre-operative (A) MRI and (B) CT demonstrating OPLL and OYL at C6–7 causing circumferential cord compression in a patient with ankylosing spondylitis and fused spine above and below C6–7 level. Careful design of the fusion construct with consideration in spinal alignment and biomechanics can help to reduce the rate of junctional problems. SSI may be reduced with meticulous wound closure that minimizes dead space, drain placement, and the use of intra-wound antibiotics. Neurologic deficits may be reduced with adequate intraoperative decompression of neural elements. Reducing the modifiable risk factors pre-operatively can decrease the overall complication rate. Finally, increased biomechanical stress on the upper instrumented vertebra (UIV) and lowest instrumented vertebra (LIV) may predispose patient to chronic degeneration and result in adjacent level degeneration and/or junctional problems. Second, wound healing and arthrodesis may be impaired due to poor blood flow due to various patient factors such as smoking, diabetes, increased frailty, steroid use, and other medical comorbidities. ![]() First, higher number of fusion levels, obesity, and more complex pathologies can increase the invasiveness of the planned procedure, thus increase complications. Three principal mechanisms are thought to contribute to complications. The most common immediate complications include acute blood loss anemia, surgical site infection (SSI), C5 palsy, and incidental durotomy the most common long-term complications include adjacent segment degeneration, junctional kyphosis, and pseudoarthrosis. The overall complication rates of PCF are estimated to range from about 15% to 25% in the current literature. ![]() We performed a comprehensive literature review to identify the most common complications following PCF using PubMed, Cochrane Database of Systematic Reviews, and Google Scholar. However, there are various complications associated with PCF that can negatively impact patient outcome. Policy of Dealing with Allegations of Research MisconductĪbstract: Posterior cervical decompression and fusion (PCF) is a common surgical technique used to treat various cervical spine pathologies.Policy of Screening for Plagiarism Process. ![]()
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