Published online Jun 29, 2016.
https://doi.org/10.4184/jkss.2016.23.2.77
Factors Associated with Early Postoperative Complications in Patients with Cervical Spondylotic Myelopathy
Abstract
Study Design
Retrospective
Objectives
To investigate factors related to early postoperative complications of surgery for cervical spondylotic myelopathy (CSM).
Summary of Literature Review
Factors associated with increased risk of complications from surgery for CSM are greater age, greater estimated blood loss, longer operative duration, and anterior-posterior combined procedures.
Materials and Methods
The records of patients (male 32, female 19, mean age 61 years) who underwent surgery for CSM between November 2004 and December 2014 were investigated for early postoperative complications and potentially related factors. Factors considered were age, gender, duration of symptoms, diabetes, smoking, comorbidity, preoperative Japanese Orthopedic Association (JOA) score, numbers of cervical levels involved, ossification of the posterior longitudinal ligament (OPLL), operative approach, fusion, operative duration, estimated blood loss (EBL), maximal cord compression ratio on MRI, and cord signal intensity change on T2-weighted MRI.
Results
Early postoperative complications were observed in 12 of 51 patients and included motor weakness in 3, pneumonia in 2, and delirium, dysphagia, hematoma, pulmonary thromboembolism, sore, seizure, wound dehiscence, and superficial infection, each in 1. Factors associated with early postoperative complications were operative duration (p=0.024), maximal cord compression ratio on MRI (p=0.009), and cord signal intensity change on T2-weighted MRI (p=0.009). The other factors were not found to correlate significantly.
Conclusions
Factors associated with early postoperative complications for CSM are operative duration, compression ratio at the level of maximal cord compression on MRI, and cord signal intensity change on T2-weighted MRI.
Table 1
Complications following surgery for cervical spondylotic myelopath
Table 2
Demographic data
Table 3
Factors affecting complications following surgery for cervical spondylotic myelopathy
References
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Macagno A, Liu S, Marascalchi BJ, et al. Perioperative Risks Associated with Cervical Spondylotic Myelopathy Based on Surgical Treatment Strategies. Int J Spine Surg 2015;9:24.
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Handa Y, Kubota T, Ishii H, et al. Evaluation of prognostic factors and clinical outcome in elderly patients in whom expansive laminoplasty is performed for cervical myelopathy due to multisegmental spondylotic canal stenosis. A retrospective comparison with younger patients. J Neurosurg 2002;96:173–179.
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Nagano A, Miyamoto K, Hosoe H, et al. Surgical treatment for cervical myelopathy in patients aged > 80 years. Orthopedics 2004;27:45–48.
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