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Survey Examines Spine Surgery Complication in Japan

Survey of 5,641 cervical spine surgeries shows the complication can be successfully managed

FRIDAY, April 11 (HealthDay News) -- In Japan, the incidence of vertebral artery injury during cervical spine surgery is similar to or slightly less than that reported in the literature. In many cases, this potentially catastrophic complication can be successfully managed with tamponade, according to a report published in the April issue of Spine.

Masashi Neo, M.D., Ph.D., of Kyoto University in Kyoto, Japan, and colleagues sent questionnaires to seven spine surgeon groups and 25 general orthopedist groups, of whom 89 percent responded.

The researchers found that there were eight cases of vertebral artery injury among 5,641 cervical spine surgeries, which represented an overall incidence of 0.14 percent. They also found that the incidences in anterior cervical decompression procedures and Magerl fixation were 0.18 percent and 1.3 percent, respectively. There were no cases associated with cervical pedicle screw fixation and one case was associated with C1 lateral mass screw fixation, which was successfully treated with tamponade. There were no reported deaths or apparent postoperative neurologic sequelae.

"Tamponade was effective in many cases, but prompt consultation with an endovascular team is recommended if the bleeding is uncontrollable," the authors conclude. "Preoperative careful evaluation of the vertebral artery seems to be most important to prevent iatrogenic vertebral artery injury and to avoid postoperative neurologic sequelae.

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