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CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0046-1815928
Original Article

Postoperative Pulmonary Complications after Craniovertebral Junction Anomaly Surgery: A Prospective Observational Study

Autor*innen

  • Shashank Paliwal 

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    2   Department of Anaesthesia, All India Institute of Medical Sciences, Bathinda, Punjab, India

  • Kiran Jangra 

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Ashwini Reddy 

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Kirandeep Kaur

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    3   Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

  • Pravin Salunke

    4   Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Ashutosh Aggarwal

    5   Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Hemant Bhagat

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Nidhi Panda 

    1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Background

Although respiratory dysfunction is commonly seen in patients with craniovertebral junction (CVJ) anomalies, pulmonary complications following CVJ surgery have not been extensively studied. We studied the incidence of postoperative pulmonary complications (PPCs) after CVJ surgeries and determined the risk factors. We also evaluated the association between the preoperative pulmonary reserve and PPC.

Methods

This prospective observational study was performed in 41 patients aged 12 to 65 years undergoing surgery for CVJ anomalies. The preoperative pulmonary reserve was assessed with bedside tests (breath holding time [BHT], single breadth count [SBC], and chest expansion) and using a spirometer (forced vital capacity [FVC], forced expiratory volume [FEV1], FEV1/FVC, peak expiratory flow rate). Postoperatively, the incidence of PPC was assessed, and the duration of mechanical ventilation/tracheostomy was noted. Spirometry was repeated after 3 months.

Results

The incidence of PPCs was 26.8%, and respiratory support requirement was commonly seen (54.5%). Bedside PFTs, including BHT, SBC, and chest expansion (p = 0.045, 0.001, and 0.012, respectively), along with blood loss (p = 0.013), had a significant association with PPCs. Multivariate analysis revealed a significant association of PPC with blood loss. There was a decline in FEV1 in the postoperative period, followed by improvement after 3 months.

Conclusion

The incidence of PPC following CVJ surgery is relatively high (26.8%), and intraoperative blood loss is an independent risk factor. Bedside PFTs like chest expansion may be superior to spirometry tests in predicting the risk of PPC.

Keywords

craniovertebral junction anomaly - pulmonary function tests - spirometry - bedside pulmonary function test - pulmonary complications


Publikationsverlauf

Artikel online veröffentlicht:
28. Januar 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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