Is There a Risk of Perioperative Stroke Due to the Retraction Used During Anterior Cervical Discectomy?

Study Overview
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Brief Summary
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In anterior cervical disc surgery, head and neck extansion position and, surgical retraction used while reaching the anterior surface of the cervical vertebra can be affect the carotid blood flow and constituting a risk for cerebral ischaemia. In this study, we planned to investigate the relationship between head position and retraction, cerebral oxygenation and postoperative cognitive functions in patients undergoing anterior cervical disc surgery.

Official Title
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Is There a Risk of Perioperative Stroke Due to the Retraction Used During Anterior Cervical Discectomy?

Conditions
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Cervical Disc Disease, Cervical Stenosis, Cervical Disc Herniation

Intervention / Treatment
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* Device: Near infrared spectroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18-70 years Preoperative Mini-Mental State Examination score of 27-30 Who were planned to undergo anterior cervical disc surgery under general anesthesia Exclusion Criteria: Patients with hypertension, severe pulmonary disease, anaemia, cardiac disease, ischaemic cerebrovascular disease, renal disease, hepatic disease, pregnancy, uncontrolled diabetes mellitus, stricture or obstruction in the carotid or vertebral arteries or Body mass index (BMI) >30.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group self-retaining retractor<br>Patients used self-retaining retractor for surgery | Device: Near infrared spectroscopy<br>* The Near Infrared Spectroscopy (NIRS) is the method used for monitorize the risk of the development of cerebral ischaemia while providing information about brain tissue oxygenation.<br>|
| Group Hand-held retractor<br>Patients used hand held retractor for surgery | Device: Near infrared spectroscopy<br>* The Near Infrared Spectroscopy (NIRS) is the method used for monitorize the risk of the development of cerebral ischaemia while providing information about brain tissue oxygenation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Near-infrared spectroscopy (NIRS) | Evaluate the effect of head position and surgical retraction on brain oxygenization with NIRS. Near-infrared spectroscopy (NIRS) is a brain imaging method that measures light absorbance to calculate oxy-hemoglobin (oxy-HB) and deoxy-hemoglobin (deoxy-HB), which provides an indirect measure of brain activity, particularly in the frontal cortex. | Intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini-Mental State Examination | Evaluate the effect of head position and surgical retraction on cognitive functions with using mini-mental state examination . A Mini-Mental State Examination (MMSE) is a set of 30 questions that commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory) | 2 hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral blood oxygenation, Near infrared spectroscopy, Cervical disc disease, Cervical microsurgery