Risks of cervical spine surgery

We all know that all surgeries involve risks, because surgery requires incision, which can cause great damage to our nerves. If the operation fails accidentally and the nerves are touched, it may cause a big change in your entire life. The cervical spine itself is a very fragile area, and surgery involves certain risks, but some patients with cervical spondylosis must undergo surgery.

Scientifically speaking, the risks of cervical spine surgery cannot be generalized and are related to several most important factors - the condition and diagnosis, the surgeon's knowledge and experience, the surgical approach and method, hospital conditions and equipment, the overall level and sense of responsibility of the medical staff in the ward, and the patient's understanding and cooperation with the treatment of the disease.

1. Condition and diagnosis: Even for the same cervical spine surgery, the reasons for the surgery are different. The condition and diagnosis directly affect the difficulty and success rate of the surgery. Situations with higher risks account for a very small number of overall cervical spine surgeries. Common conditions that are difficult to operate on and have high risks include extensive cervical tumors, severe ossification of the posterior longitudinal ligament (OPLL), cervical fracture-dislocation, peak period of spinal cord injury edema, severe long-segment cervical spinal stenosis, complex lesions of the upper cervical spine (C1, C2), cervical kyphosis, etc. These difficult injuries account for about 5-10% of the total surgeries, while the vast majority of the others are general cervical spondylosis, disc herniation, fracture-dislocation, OPLL, cervical spinal stenosis, etc., and the surgical reliability is relatively higher.

The high-risk factors for surgical treatment of cervical spondylosis include: 1. Severe cervical spinal stenosis, long delay before surgery, severe condition, and nerve adhesion; 2. Elderly and frail patients, with a relatively high incidence of postoperative complications in patients over 70 to 80 years old; 3. Patients with serious comorbidities before surgery, such as diabetes, cardiovascular and cerebrovascular diseases, liver and kidney dysfunction, etc., which will increase the probability of perioperative complications.

Bulk data from home and abroad (similar to our observations) show that the effectiveness of cervical spondylosis treatment is around 80-90%, but surgical results are not obvious in around 10% of patients. Analysis shows that this is directly related to the fact that some nerves have already degenerated and necrotic. Taking all patients who underwent cervical spine surgery together, the rate of curable surgical complications is generally 5-10%, the rate of permanent neurological loss (paralysis or significant loss of limb function) is around 0.3%, and the incidence of death due to surgical and hospitalization complications is around 0.2%.