Freedman, Brett A a; Potter, Benjamin K a; Kuklo, Timothy R a,b
Purpose of review: Cervical spine surgical techniques and instrumentation continue to evolve, while the neurologic complication rates continue to decline steadily. Currently, this remains at approximately 0-3.7%. The purpose of this manuscript is to review neurologic complications secondary to cervical spine surgery and provide evidenced-based management strategies to be used when complications do occur.
Recent findings: The most important recent advancements in the treatment and prevention of neurologic complications in cervical spine surgery have come in the areas of advanced intraoperative neuromonitoring techniques and pharmacological management of spinal cord and nerve root injuries with agents such as GM-1 ganglioside, tirilizad, and others.
Summary: An understanding of the pathophysiology, specifically the primary and secondary phases, of neural injury will ultimately improve prevention and management of these injuries.
Current Opinion in Orthopedics. 16(3):169-177, June 2005.