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Incidences, causes and risk factors of unplanned reoperation within 30 days of craniovertebral junction surgery: a single-center experience

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Abstract

Purpose

To investigate the incidences, causes, and risk factors for unplanned reoperation within 30 days of craniovertebral junction (CVJ) surgery.

Methods

From January 2002 to December 2018, a retrospective analysis of patients who underwent CVJ surgery at our institution was conducted. The demographics, history of the disease, medical diagnosis, approach and type of operation, surgery duration, blood loss, and complications were recorded. Patients were divided into the no-reoperation group and the unplanned reoperations group. Comparison between two groups in noted parameters was analyzed to identify the prevalence and risk factors of unplanned revision and a binary logistic regression was performed to confirm the risk factors.

Results

Of 2149 patients included, 34(1.58%) required unplanned reoperation after the initial surgery. The causes for unplanned reoperation contained wound infection, neurologic deficit, improper screw placement, internal fixation loosens, dysphagia, cerebrospinal fluid leakage, and posterior fossa epidural hematomas. No statistical difference was found in demographics between two groups (P > 0.05). The incidence of reoperation of OCF was significantly higher than that of posterior C1-2 fusion (P = 0.002). In terms of diagnosis, the reoperation rate of CVJ tumor patients was significantly higher than that of malformation patients, degenerative disease patients, trauma patients, and other patients (P = 0.043). The binary logistic regression confirmed that different disease, fusion segment (posterior) and surgery time were independent risk factors.

Conclusions

The unplanned reoperation rate of CVJ surgery was 1.58% and the major causes were implant-related failures and wound infection. Patients with posterior occipitocervical fusion or diagnosed with CVJ tumors had an increased risk of unplanned reoperation.

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Author notes

  1. Hong Xia & Changrong Zhu

    Present address: Department of Orthopedic, People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou, China

Authors and Affiliations

  1. The First School of Clinical Medicine, Southern Medical University, Guangzhou, China

    Hu Chen, Peirong Lian, Qiang Tu, Jianhua Wang, Xiangyang Ma, Honglei Yi, Hong Xia & Changrong Zhu

  2. Department of Orthopedic, People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou, China

    Hu Chen, Peirong Lian, Qiang Tu, Jianhua Wang, Xiangyang Ma & Honglei Yi

  3. Department of Orthopedic, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, China

    Fuzhi Ai

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Contributions

All authors contributed to the study’s conception and design. Data collection and analysis were performed by CZ, HC, and PL. The first draft of the manuscript was written by CZ and HC. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Hong Xia or Changrong Zhu.

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Conflict of interest

We acknowledge support from the following grants: ①the Science and Technology Planning Project of Guangzhou City (NO.202102021254, C Z);②the Science and Technology Planning Project of Guangdong Province (2017B030314139, H X). These grants had no role in the design or execution of this study or the reporting of results. All the authors declare that they had no conflict of interest.

Ethics approval

This is an observational study. The General Hospital of Southern Theatre Command Research Ethics Committee has confirmed that no ethical approval is required.

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Informed consent was obtained from all individual participants included in the study.

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Chen, H., Lian, P., Tu, Q. et al. Incidences, causes and risk factors of unplanned reoperation within 30 days of craniovertebral junction surgery: a single-center experience. Eur Spine J 32, 2157–2163 (2023). https://doi.org/10.1007/s00586-023-07729-x

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