PREOPERATIVE PROTOCOL AND MORBIMORTALITY IN CERVICAL SURGERY WITH ANTERIOR APPROACH

ABSTRACT Objective: To determine the correlation between morbidity/mortality and the pre-surgical protocol in patients undergoing anterior cervical surgical approach. Methods: Retrospective, cross-sectional and descriptive study, in which 114 patients who underwent anterior cervical surgical approach were reviewed, divided into two groups: “Group A” Conventional Presurgical Protocol (CPP) and “Group B” Extended Presurgical Protocol (EPP). Statistical analysis used the IBM SPSS Statistics Base v.24 software. Results: We evaluated 114 patients, 35 from “Group A”, 79 from “Group B”, 83 (72.8%) with cervical myelopathy, 30 (26.3%) with cervicobrachialgia. “Group A” had 10 cases of respiratory failure, with 5 secondary to bronchial secretion, 2 secondary to cervical hematoma. “Group B” had 12 cases of respiratory failure, 3 secondary to bronchial secretion and 1 secondary to cervical hematoma. Conclusions: The extended presurgical protocol can be the answer to reduce complications by improving selection parameters of the candidate patient for a surgical procedure of the cervical spine. Level of Evidence III; Case-control studyg.

摘要
研究目的：明确接受颈椎前入路手术患者的发病/死亡情况与术前方案之间的相关性。
研究方法：本研究为回顾性、横断面描述性研究，回顾了114例行颈椎前入路手术的患者资料，将其分为两组："Group A"为常规术前方案（Conventional Presurgical Protocol, CPP）组，"Group B"为强化术前方案（Extended Presurgical Protocol, EPP）组。统计学分析采用IBM SPSS Statistics Base v.24软件完成。
研究结果：本研究共纳入114例患者，其中A组35例，B组79例；83例（72.8%）为脊髓型颈椎病，30例（26.3%）为颈臂痛。A组出现呼吸衰竭10例，其中5例继发于支气管分泌物潴留，2例继发于颈椎血肿；B组出现呼吸衰竭12例，其中3例继发于支气管分泌物潴留，1例继发于颈椎血肿。
研究结论：强化术前方案可通过优化颈椎手术候选患者的筛选参数，从而降低手术并发症发生率。本研究证据等级为Ⅲ级，属于病例对照研究。