Airway Complications After Anterior Cervical Spine Surgery: Etiology and Risk Factors

Luis Felipe Colón; Lauren Barber; Ellen Soffin; Todd J Albert; Yoshihiro Katsuura

doi:10.1177/21925682231160072

Airway Complications After Anterior Cervical Spine Surgery: Etiology and Risk Factors

Global Spine J. 2023 Oct;13(8):2526-2540. doi: 10.1177/21925682231160072. Epub 2023 Mar 9.

Authors

Luis Felipe Colón¹, Lauren Barber², Ellen Soffin³, Todd J Albert², Yoshihiro Katsuura⁴

Affiliations

¹ Department of Orthopaedic Surgery, University of Tennessee College of Medicine in Chattanooga, Chattanooga, TN, USA.
² Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
³ Department of Anesthesiology, Critical Care, and Pain Management; Hospital for Special Surgery, New York, NY, USA.
⁴ Department of Orthopaedic and Spine Surgery, Adventist Health Howard Memorial Hospital, Willits, CA, USA.

Abstract

Study design: Narrative Review.

Objective: To provide an overview of etiology and risk factors of airway complications after anterior cervical spine surgery (ACSS).

Methods: A search was performed in PubMed and adapted for use in other databases, including Embase, Cochrane Library, Cochrane Register of Controlled Trials, Health Technology Assessment database, and NHS Economic Evaluation Database.

Results: 81 full-text studies were reviewed. A total of 53 papers were included were included in the review and an additional four references were extracted from other references. 39 papers were categorized as etiology and 42 as risk factors.

Conclusions: Most of the literature on airway compromise after ACSS is level III or IV evidence. Currently, there are no systems in place to risk-stratify patients undergoing ACSS regarding airway compromise or guidelines on how to manage patients when these complications do occur. This review focused on theory, primarily etiology and risk factors.

Keywords: Ossification of posterior longitudinal ligament; airway complications; airway compromise; anterior cervical discectomy and fusion; anterior cervical spine surgery; cerebrospinal fluid leak; obstructed airway; outpatient cervical spine surgery; postoperative hematoma; systematic review.