Risk Factors Analysis And Control Strategies Of Wound Hematoma After Anterior Cervical Spine Surgery

Objective: To explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery.Summarize the clinical signs and treatment methods of wound hematoma and reduce the incidence of wound hematoma after anterior cervical surgery.Methods: Clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by our senior spine surgeon from January 2011 to December 2017 were evaluated.The patients with anterior cervical incision hematoma were identified,and collect all patients’ age,gender,BMI,symptoms,procedures,surgical levels,operative time,blood loss,preoperative comorbidities and anticoagulant drug use through the medical record system.All patients with wound hematoma were classified as case group and the rest as the control group,and a Logistic regression model was established.All patients were followed-up for neck function using the neck disability index(NDI)score.Results: 13 patients were identified as wound hematoma among all678 patients who were underwent anterior cervical spine surgery.The Logistic regression identified that history of hypertension was independent risk factors of hematoma formation(p=0.004 OR=5.524 95%CI 1.744-17.500).Conclusion: History of hypertension is the risk factor for hematoma formation.Meticulous hemostasis,moderate muscle subtraction,and perioperative airway management are critical in avoiding hematoma development.Attention should be paid to the complaint of the patient after surgery.Once the hematoma was found,surgical evacuation is inevitable.It is not recommended to carry out treatment beside the bed.