Complications associated with anterior cervical spine surgery: A systematic review of literature
Bibliographic record
Abstract
Introduction: Anterior cervical spine surgery has become a widely accepted approach for treating various cervical spine pathologies. Research question: This systematic review aimed to evaluate the frequency, etiology and outcomes of complications associated with anterior cervical spine surgery. Material/methods: A comprehensive literature search was conducted using multiple databases (CINAHL Plus, MEDLINE, PubMed, Scopus, and EMBASE) for peer-reviewed articles published in English from January 1st, 1989 to December 31st, 2024. Studies involving adult patients undergoing anterior cervical spine surgery were included. The quality of evidence was assessed using the Newcastle Ottawa Scale. Results: Dysphagia emerged as the most common complication, with rates varying widely (2.3 %-87.5 %) depending on timing of assessment and methodology. Other significant complications included adjacent segment disease with the range varying from 0.4 % to 32 %, recurrent laryngeal nerve palsy (0.1 %-9 %), infection (0.39 %-8.5 %), pseudarthrosis (0.25 %-31 %), esophageal perforation (0.1 %-0.45 %), vertebral artery injury (0.3 %-7.7 %), Horner's syndrome (0.06 %-0.45 %), graft failure (2.7 %-35.5 %), CSF leak (0 %-1 %), postoperative hematoma (0.21 %-7 %) and deteriorating or new neurological deficits (0.37 % -3.3). Multilevel disease, revision surgery and OPLL were associated with higher complication rate. Surgeon's experience and higher case volume were consistently correlated with lower complication rates. Discussion & conclusion: While anterior cervical spine surgery is generally safe and effective, it carries risks of various complications ranging from common but typically self-limiting to rare but potentially severe. Μinimizing these complications depends on thorough preoperative planning, careful patient selection, and proper surgical technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.041 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.016 | 0.020 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".