KMID : 1145220190160030548
|
|
Neurospine 2019 Volume.16 No. 3 p.548 ~ p.557
|
|
Preoperative Narcotic Use, Impaired Ambulation Status, and Increased Intraoperative Blood Loss Are Independent Risk Factors for Complications Following Posterior Cervical Laminectomy and Fusion Surgery
|
|
Badiee Ryan K.
Chan Andrew K. Rivera Joshua Molinaro Annette Doherty Brianna R. Riew K. Daniel Chou Dean Mummaneni Praveen V. Tan Lee A.
|
|
Abstract
|
|
|
Objective: This retrospective cohort study seeks to identify risk factors associated with complications following posterior cervical laminectomy and fusion (PCLF) surgery.
Methods: Adults undergoing PCLF from 2012 through 2018 at a single center were identified. Demographic and radiographic data, surgical characteristics, and complication rates were compared. Multivariate logistic regression models identified independent predictors of complications following surgery.
Results: A total of 196 patients met the inclusion criteria and were included in the study. The medical, surgical, and overall complication rates were 10.2%, 23.0%, and 29.1% respectively. Risk factors associated with medical complications in multivariate analysis included impaired ambulation status (odds ratio [OR], 2.27; p=0.02) and estimated blood loss over 500 mL (OR, 3.67; p=0.02). Multivariate analysis revealed preoperative narcotic use (OR, 2.43; p=0.02) and operative time (OR, 1.005; p=0.03) as risk factors for surgical complication, whereas antidepressant use was a protective factor (OR, 0.21; p=0.01). Overall complication was associated with preoperative narcotic use (OR, 1.97; p=0.04) and higher intraoperative blood loss (OR, 1.0007; p=0.03).
Conclusion: Preoperative narcotic use and estimated blood loss predicted the incidence of complications following PCLF for CSM. Ambulation status was a significant predictor of the development of a medical complication specifically. These results may help surgeons in counseling patients who may be at increased risk of complication following surgery.
|
|
KEYWORD
|
|
Posterior cervical fusion, Complication, Risk factor, Narcotics, Cervical spondylotic myelopathy
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|