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Open Access 06-09-2024 | Tracheostomy | Original Article

Percutaneous dilational tracheostomy following anterior cervical spine fixation – a retrospective propensity-matched cohort study

Authors: Ronny Meisterfeld, Anne Queck, Alexander Carl Disch, Marius Distler, Hanns-Christoph Held, Janusz von Renesse, Klaus-Dieter Schaser, Jürgen Weitz, Konrad Kamin

Published in: European Spine Journal

Abstract

Purpose

In patients with traumatic, infectious, degenerative, and neoplastic surgical indications in the cervical spine, commonly the anterior approach is used. Often these patients require a tracheostomy necessary due to prolonged mechanical ventilation. The limited spinal mobility and proximity to the surgical site of anterior cervical spine fixation (ACSF) could pose an increased risk for complications of percutaneous dilational tracheostomy (PDT.) Importantly, PDT might raise wound infection rates of the cervical spine approach. The aim of this study is to prove safety of PDT after ACSF.

Methods

We performed a retrospective, single-center study comparing patients with and without ACSF who underwent Ciaglia-single step PDT. After propensity score matching using logistic regression, we compared intra- and postprocedural complication rates. Furthermore, surgical site infections were evaluated. Putensen’s definitions of complications and Clavien-Dindo’s classification were used.

Results

A total of 1175 patients underwent PDT between 2009 and 2021. Fifty-seven patients underwent PDT following ACSF and were matched to fifty-seven patients without ACSF. The mean interval between ACSF and PDT was 11.3 days. The overall complication rate was 19.3% in the ACSF group and 21.1% in the non-ACSF group. The mean follow-up was 388 days (± 791) in the ACSF group and 424 days (± 819) in the non-ACSF group. Life-threatening complications (Clavien-Dindo IV to V) were found in 1.8% of ACSF patients and 3.5% of non-ACSF patients. There were no significant differences in complication rates. No surgical site infection of the anterior spine access was detected.

Conclusion

PDT is a feasible and safe procedure in patients after ACSF. Complication rates are comparable to patients without ACSF. Surgical site infections of ACSF are very rare.

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Title: Percutaneous dilational tracheostomy following anterior cervical spine fixation – a retrospective propensity-matched cohort study
Authors: Ronny Meisterfeld
Anne Queck
Alexander Carl Disch
Marius Distler
Hanns-Christoph Held
Janusz von Renesse
Klaus-Dieter Schaser
Jürgen Weitz
Konrad Kamin
Publication date: 06-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Tracheostomy
Postoperative Wound Infection
Postoperative Wound Infection
Published in: European Spine Journal
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-024-08484-3

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Springer Medicine

Percutaneous dilational tracheostomy following anterior cervical spine fixation – a retrospective propensity-matched cohort study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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