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Percutaneous dilational tracheostomy following anterior cervical spine fixation - a retrospective propensity-matched cohort study.
Meisterfeld, Ronny; Queck, Anne; Disch, Alexander Carl; Distler, Marius; Held, Hanns-Christoph; von Renesse, Janusz; Schaser, Klaus-Dieter; Weitz, Jürgen; Kamin, Konrad.
Afiliación
  • Meisterfeld R; Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany. ronny.meisterfeld@uniklinikum-dresden.de.
  • Queck A; University Centre of Surgery Intensive Care Unit, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany. ronny.meisterfeld@uniklinikum-dresden.de.
  • Disch AC; Department of Medicine I, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • Distler M; University Centre for Orthopaedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • Held HC; University Comprehensive Spine Center, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • von Renesse J; Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • Schaser KD; University Centre of Surgery Intensive Care Unit, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • Weitz J; Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
  • Kamin K; University Centre for Orthopaedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, University of Technology Dresden, Dresden, Germany.
Eur Spine J ; 2024 Sep 06.
Article en En | MEDLINE | ID: mdl-39240289
ABSTRACT

PURPOSE:

In patients with traumatic, infectious, degenerative, and neoplastic surgical indications in the cervical spine, commonly the anterior approach is used. Often these patients require a tracheostomy necessary due to prolonged mechanical ventilation. The limited spinal mobility and proximity to the surgical site of anterior cervical spine fixation (ACSF) could pose an increased risk for complications of percutaneous dilational tracheostomy (PDT.) Importantly, PDT might raise wound infection rates of the cervical spine approach. The aim of this study is to prove safety of PDT after ACSF.

METHODS:

We performed a retrospective, single-center study comparing patients with and without ACSF who underwent Ciaglia-single step PDT. After propensity score matching using logistic regression, we compared intra- and postprocedural complication rates. Furthermore, surgical site infections were evaluated. Putensen's definitions of complications and Clavien-Dindo's classification were used.

RESULTS:

A total of 1175 patients underwent PDT between 2009 and 2021. Fifty-seven patients underwent PDT following ACSF and were matched to fifty-seven patients without ACSF. The mean interval between ACSF and PDT was 11.3 days. The overall complication rate was 19.3% in the ACSF group and 21.1% in the non-ACSF group. The mean follow-up was 388 days (± 791) in the ACSF group and 424 days (± 819) in the non-ACSF group. Life-threatening complications (Clavien-Dindo IV to V) were found in 1.8% of ACSF patients and 3.5% of non-ACSF patients. There were no significant differences in complication rates. No surgical site infection of the anterior spine access was detected.

CONCLUSION:

PDT is a feasible and safe procedure in patients after ACSF. Complication rates are comparable to patients without ACSF. Surgical site infections of ACSF are very rare.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania