einstein (São Paulo). 11/Sep/2025;23:eAO1830.
Posterior cervical spine surgery epidemiology and complications: a large retrospective case series
DOI: 10.31744/einstein_journal/2025AO1830
Highlights
■ Posterior cervical spine surgery showed an overall complication rate of 22.3%, mainly surgery-related.
■ Surgical site infection (6.2%) and late reoperation (4.3%) were the most common complications.
■ The average patient age varied by etiology, being the lowest in neoplastic cases (34.4 years) and the highest in degenerative cases (55.7 years).
■ No statistically significant associations were found between complications and patient characteristics, except for a trend toward more complications in urgent surgeries (p=0.085).
■ Mortality was 3.7%, mainly among patients with traumatic cervical injuries and severe preoperative spinal cord dysfunction.
ABSTRACT
Objective:
Posterior cervical spine surgery is used to decompress and/or stabilize the spine for the treatment of various spinal diseases. The aim of this study was to evaluate the clinical characteristics, surgical indications, and complications of patients who underwent posterior cervical spine surgery at a tertiary center.
Methods:
This retrospective cohort/case series study included data from patients who underwent posterior cervical spine surgery at a tertiary hospital to treat different cervical diseases.
Results:
A total of 161 patients were included. One hundred six (65.8%) patients were men, and mean age was 45.1 years. Patients with neoplastic diseases had the lowest mean age, whereas those with traumatic and degenerative diseases had the highest (p<0.001). Thirty-six patients (22.3%) experienced at least one complication. Serious adverse effects were infrequent despite six deaths (3.7%), and among the non-serious complications, surgical site infection (6.2%) and the need for late reoperation (4.3%) were the most common. No specific patient characteristics were associated with complications; however, a trend toward complications in urgent procedures was noted (p=0.085).
Conclusion:
Posterior cervical spine surgery was more common in men, and patients with degenerative diseases had a higher average age. There was no statistically significant association between complications and patient characteristics, with a trend toward more clinical complications during urgent procedures. Serious complications were infrequent in elective procedures; however, a small risk of death was noted, particularly in patients with trauma-related cervical spine injuries. Understanding the epidemiology and complications is fundamental for preoperative counseling and the prevention of complications.
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