The spine journal : official journal of the North American Spine Society
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Dysphagia is a common postoperative complication in patients undergoing occipitocervical fusion (OCF). Previous studies had proposed the use of two measures-the occipital to C2 angle (O-C2a) and the occipital and external acoustic meatus to axis angle (O-EAa)-to predict postoperative dysphagia after OCF. However, these studies had small sample sizes and the predictive abilities of both measures are still not clear. ⋯ Both O-EAa and O-C2a could be critical predictors for postoperative dysphagia. During surgery, ensuring that the O-EAa exceeds 100° and simultaneously avoiding an O-C2a reduction greater than 5° could effectively avert postoperative dysphagia.
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Perioperative complications affect surgical outcomes. Classification systems of perioperative complications are well established and widely applied in many surgical fields other than spine surgery. ⋯ A comprehensive classification system for perioperative complications in spine surgery (considering four categories) is presented and validated. The categories therapeutic consequence (A-E) and decrease in neurological function correlate strongly with hospital stay.