“A retrospective analysis of demographic, clinical and postoperative data of all cervical spine patients operated at a spine center - Our experience of 18 yearsâ€

As the mean age of population increase, the percentage ofpopulation with cervical spine disorders invariably increases. Cervical spinesurgery improves outcomes in select patients with cervical spine pathology.With newer technologies and surgical techniques, there has been a significantimprovement in cervical spine patient outcomes in the recent years. Mostoperative cervical pathologies can be treated by anterior [ACDF, ACCF, TDR,etc.] or by posterior approach [Laminectomy with or without instrumentation, OCfusion, Post. C1, C2 fixation, etc.]. Clinical decision making andevidence-based medicine makes up a huge part in management of cervical spinecases, however generating high quality data in spine surgery is plagued withunique challenges.

 Currentlymost of the clinical research in spine consider a follow-up in a range of 2-5years. Long term effects of surgical intervention on the spine invariably leadto altered biomechanics and kinematics in the spine3. Problems likeadjacent segment degeneration (ASD) are a known entity to occur in asignificant number of cases on a longer follow-up. Longer term studies might begiving a better insight in the effects that a surgery might have had on thepatients

 Anotherdimension which is rarely taken into consideration in studies is the learningcurve any institution invariably goes through in its process of maturation.Similar surgical candidates operated on by the same surgeon 10 years apartmight have significant differences in outcomes, due to evolution of surgeoncapabilities, resources and patient management protocols over time.

 We havebeen privileged enough to cater to large volumes of spine patients in ourcenter, and it has also enabled us to implement some enabling technologies,which include the use of intraoperative CT scans, navigation, use of ultrasonicbone scalpel, intraoperative neuromonitoring and latest improvements in surgicallyimplanted materials just to name a few. Apart from improvements in OTcapabilities, we were also able to develop resources in data management, likeelectronic medical records (EMR) and picture archiving and communication system(PACS). That along with meticulous protocols of data entry has enabled us tohave access to vast amounts of clinical patient data.

 Properanalysis of this data can provide us with insights not only of patient outcomesbut also of learning curves over time, unique complication and ways of managingthem, and how enabling technologies might have improved surgical outcomes.

 Objective of the study:

 Our goal for this project is to do a retrospective analysisof all the patients operated for cervical spine at our institute and assessoutcomes and various other parameters over time.