Cervical Spine Deformity

Indications, Considerations, and Surgical Outcomes

Samuel K. Cho, MD; Scott Safir, MD; Joseph M. Lombardi, MD; Jun S. Kim, MD


J Am Acad Orthop Surg. 2019;27(12):e555-e567. 

In This Article


Complications resulting from cervical deformity surgery are numerous and include implant displacement, graft dislodgement, pseudarthrosis, dysphagia, hoarseness, wound infection, dural tear, pneumonia, neurologic deficits, airway issues, and vertebral artery injury.[13] Complications can be divided into categories based on the operative technique. Anterior approaches are more likely to cause vocal cord palsy, tracheal/esophageal injury, graft failure, and infection or hematoma. The posterior approach is associated with higher rates of spinal cord or nerve root injury, hardware failure or fracture, nonunion, vertebral artery injury, and infection or hematoma. Finally, osteotomies are likely to cause infectious, respiratory, and cardiovascular morbidities.

A review of a multicenter database for adult patients undergoing cervical deformity surgery found 52 early complications (≤30 days postop) of 78 patients, with 28.2% of patients having ≥1 minor complication and 24.4% of patients having ≥1 major complication.[34] Of the three approaches (anterior, posterior, and combined), some have found the combined approach to be most fraught with complications at a rate of 40% versus 30% and 27% for anterior and dorsal, respectively.[35]