Abstract

Introduction
There is no consensus regarding anterior or posterior cervical spine approach for pathologies in the cervical spine. Combined anterior and posterior cervical spine surgery, even though negates the disadvantages of a single approach, is however fraught with challenges.
The aim of the study is to analyse the complications of single stage combined anterior and posterior cervical spine decompression and instrumented fusion (SSAPCDF).

Method
This is a retrospective study of 44 patients (31 male and 13 females) who underwent SSAPCDF between 2013 - 2023. The indications for surgery were degenerative in 72% of patients, tumour in 15%, trauma in 9 % and infection in 2%. The complications were divided in to intraoperative and postoperative. The return to theatre within 30 days, within 90 days and within 365 days were noted. Different parameters were noted including planned and unplanned HDU and ITU admissions, and re-admission to the hospital.

Results
There were no intraoperative complications. Post-operatively, 9% of patients had wound healing complications. Two of the tumour patients had post-operative airway complications with stridor present. Return to theatre was 9% within 30 days, two were for wound washout and two for tracheostomy, this reduced to 2% within 90 days which was one patient for wound washout and closure of cervico-thoracic spine with MSCC. There was no return to theatre between 90 and 365 days. Two tumour patients had unplanned HDU and ITU admissions post-operatively, while one degenerative and one infection patient had planned ITU admissions. There is no association between indication and readmission to the hospital between 31 – 90 days or between 91 – 365 days.

Conclusion
SSAPCDF is found to be quite safe with the correct level of expertise and does not increase the risk beyond that of a normal anterior or posterior cervical spine surgery.