Incidence of Urinary Retention following Cervical Corpectomy with Iliac Bone Autografting in Single Institution

Abstract

Objective: To study the incidence of post operative urinary retention after the cervical corpectomy with iliac bone            auto-grafting.

Methods: In this retrospective study, data were collected from patients undergoing cervical corpectomy with   autologous iliac bone grafting by a single surgeon managed in a neurosurgery unit between July 2016 and October 2016.  Preoperative Nurick grade, post void residue, duration of surgery and need for catheterization postoperatively were studied.

 Results: There were 7 patients (mean age, 48.7 years, range, 26 to 59 years). Male to female ratio was 6:1. Single level corpectomy was done for 3 patients (42.9%), two level for 3 patients (42.9%) and three level corpectomy was done for 1 patient (14.3%). All patients underwent iliac bone           auto-grafting except for the fibular autograft for a 3 level  corpectomy. Most common reason for corpectomy was            ossified posterior longitudinal ligament (42.9%). Most of the patients (42.9% each) were Nurick grade 3 or 4and modified JOA score of 10 (42.9%) preoperatively. Mean post void residue was 34 mL measured preoperatively. Time under general anaesthesia was 4.5-7 hours (mean of 5.5 hours). All patients underwent cervical corpectomy using the standard technique. Operative bone defect was filled with iliac bone autograft for 6 patients and with fibular autograft for 1 patient. 2 patients were catheterized preoperatively. Out of the           remaining 5 patients, 4 (80 %) needed postoperative urinary catheterization.

 Conclusions: Cervical corpectomy with iliac bone   autografting is associated with significant iliac operative site pain leading to immobilization. Most of the patients develop urinary retention and need indwelling foley's catheterization. Preoperative catheterization may be an effective method to avoid bladder distension in these patients and could be practiced in all the patients              undergoing cervical corpectomy with iliac bone   autografting. Preoperative post void residue does not  relate to incidence of retention postoperatively.

 Keywords: urinary catheterization; cervical corpectomy; iliac bone autograft; surgery