Voice Change Associated with Anterior Cervical Fusion : Consideration for Prevalence and Prevention

During the period from Sep.,1993 to Dec.,1997, in a series of 148 patients with anterior cervical fusions on using a modified Smith-Robinson technique, long-term follow-up results complete with historical evaluation or laryngeal examination were obtained in all patients. The visualization of the underlying pathology was adequate through magnification of the operating microscope in the anterior approach.

The complications were analyzed on the basis of 157 operative cases in 148 patients treated surgically right sided approach with variable underlying pathologies. The most common complication was a postoperative hoarseness in 8(5%), but risks and complications of the procedure were few in spite of right sided approach.

Measures to minimize the incidence of vocal cord paralysis include careful surgical techique and knowledge of the surgical anatomy of the laryngeal nerves. Suggestions are given for the assessment of postoperative hoarseness, and for the management of vocal cord paralysis.