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International Orthopaedics

, Volume 40, Issue 6, pp 1157–1162 | Cite as

Tracheostomy following anterior cervical spine fusion in trauma patients

  • Harald Binder
  • Nikolaus Lang
  • Thomas M. Tiefenboeck
  • Adam Bukaty
  • Stefan Hajdu
  • Kambiz SarahrudiEmail author
Original Paper

Abstract

Purpose

Traumatic injuries to the cervical spine are frequently accompanied by cervical spinal cord injuries—often necessitating tracheostomy. The purpose of this study was to evaluate patient characteristics and outcomes after undergoing anterior cervical spine fusion (ACSF) with tracheostomy.

Methods

All patients with cervical spine injury (CSI) who underwent ACSF and tracheostomy between December 1992 and June 2014 were included in this retrospective data analysis. The study group consisted of 32 men (84 %) and six women (16 %), with an average age of 47 ± 20 years. Blunt trauma to the cervical spine was the cause of CSI in all 38 patients.

Results

The mean Injury Severity Score (ISS) was 30.50 ± 6.25. Eighteen patients sustained severe concomitant injuries related to the spinal injury. In 15 patients (39.5 %), traumatic brain injury (TBI) with fractures of the cranium and/or intracranial lesions were observed. The mean Glasgow Coma Scale (GCS) score was 11 ± 4.5 (range 3–15). Two tracheostomies (5.3 %) were performed simultaneously with ACSF. The remaining 36 were performed with an average “delay” of 15 ± ten days. We observed no difference in time to tracheostomy among patients initially presenting with an American Spinal Injury Association (ASIA) score of either A, B, C or D. Only two patients (5.3 %) were identified as having an infection at the site of ACSF after placement of a tracheostomy. There were no deaths directly related to airway difficulties in our cohort.

Conclusions

Our data show that tracheostomy is safely performed after an average of 15 days post-ACSF, thereby being associated with a very low rate of complications. However, future prospective randomised studies are needed to identify the optimal timing of tracheostomy placement after ACSF. Level of evidence: IV; retrospective case series.

Keywords

Tracheostomy ACSF Retrospective study Trauma Infection 

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Copyright information

© SICOT aisbl 2015

Authors and Affiliations

  • Harald Binder
    • 1
  • Nikolaus Lang
    • 1
  • Thomas M. Tiefenboeck
    • 1
  • Adam Bukaty
    • 2
  • Stefan Hajdu
    • 1
  • Kambiz Sarahrudi
    • 1
    Email author
  1. 1.Department of Trauma SurgeryMedical University of ViennaViennaAustria
  2. 2.Division of General Anaesthesia and Intensive Care MedicineMedical University of ViennaViennaAustria

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