A study recently published in Spine examined the infection rate for upper cervical spine surgery using the transoral approach.
The researchers examined data from 139 patients who underwent the transoral surgical procedures from April 1994 to December 2012 at a single referral center. The average age was 53.6 years old and a little more than half of the patients were male. Most of the patients had rheumatic disease, whereas tumor destruction was the indication for surgery in around 23 percent of the cases.
Another 23 percent had upper cervical spine fractures. The patients were followed for around 4.5 years. Here are five findings from the study:
1. In 2.6 percent of the patients in the solely rheumatic and tumor groups, pharyngeal wound infection occurred. These patients typically presented within the first four months.
2. One patient had a cage reconstruction after a giant cell tumor C2 presented with a late infection. The patient presented with the infection five years after surgery.
3. Debridement and primary closure were possible in two patients. Flap coverage and pharyngeal wall was necessary in three of the patients.
4. Whether the patient had an implant or not didn't have a significant impact on infections.
5. When there was an infection in the titanium cage, patients mostly needed flap coverage of the pharyngeal wall after cage removal.
"The transoral route has proved to be an invaluable method of approaching pathological lesions in the upper cervical spine," concluded the study authors. "The infection rate in this work was 3.6 percent. Patients with rheumatic diseases and patients presenting with tumors were more susceptible to postoperative surgical wounds."