Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Rao, S; Badani, KM; Jamieson, K; Schildhauer, T.
Pitfalls in the surgical management of cervical spine injuries.
Eur Spine J. 1996; 5(3): 153-160.
Doi: 10.1007/BF00395506
PubMed
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- Co-Autor*innen der Med Uni Graz
- Schildhauer Thomas Armin
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- Abstract:
- Records of 69 cervical spine injury patients referred to the authors' institution over a 3-year period were reviewed. The senior author documented "definite" and "probable" pitfalls occurring in the pre-, intra-, and postoperative management. Diagnosis, traction, bracing, surgical timing, intraoperative technical errors, and incorrect surgical decisions were noted. Of the 69 patients, 39 (56%) suffered a pitfall of management. Twenty-seven patients (39%) accumulated 49 "definite" pitfalls between them and 12 patients (17%) suffered a total of 20 "probable" pitfalls. Of the 49 definite pitfalls, 7 (14%) were preoperative, 17 (34%) were those of surgical decision making, 21 (43%) were operative, and 4 (9%) postoperative. Diagnostic errors and incorrect bracing and traction led to neurological worsening. Intraoperatively, technical errors (30%), wrong timing of surgery (24%), and incorrect choice of operation (16%) were the common pitfalls. Postoperative pitfalls consisted of inappropriate bracing (17%). A Cervical Spine Research Society review (1989) rated complications of cervical spine surgery at 6.3% (63/992). In this study, a sizeable portion (56%) of cervical spine injury patients requiring surgery were at a risk of complications. Short of complications, there are areas of management where errors may have less well-documented undesirable effects or increase the potential for morbidity. An awareness of these pitfalls and increased use of non-operative treatment may eliminate up to 73% of the pitfalls and thereby decrease the morbidity associated with the management of cervical spine injuries.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Cervical Vertebrae - injuries Cervical Vertebrae - radiography Cervical Vertebrae - surgery
- Decision Making -
- Female -
- Humans -
- Internal Fixators -
- Male -
- Medical Errors -
- Middle Aged -
- Spinal Fractures - radiography Spinal Fractures - surgery
- Spinal Fusion - methods
- Treatment Outcome -