Predicting Complications After Cervical Spondylotic Myelopathy Surgery

Category: Spine Surgery | Author: Stefano Sinicropi | Date: July 6, 2016

Cervical Spondylotic Myelopathy Surgery

Predicting the likelihood of complications is a necessary step in the surgical process because it helps surgeons identify potential pitfalls to surgery. Not every complication can be prevented, but as we begin to identify more complication biomarkers, we can slowly reduce rates of complication.

Recently, researchers set off to identify some factors that influence the likelihood of suffering a setback after cervical spondylotic myelopathy (CSM) surgery. CSM is a common condition that results in the compression of the spinal cord in the neck, which aside from causing pain, can also lead to nerve issues or disability. Not everyone who suffers from CSM needs surgery, but for those who do, the operation carries a small but definite risk of complications.

To better understand what influences complication likelihood after CSM surgery, Dr. Michael G. Fehlings and colleagues analyzed data on 479 patients who underwent surgery to fix their cervical spondylotic myelopathy. 78 patients suffered a total of 89 surgery-related complications for a rate of 16.25 percent, a very high percentage for a medical procedure.

4 Factors Influence Complication Rates

Researchers examined a wide range of clinical and surgical factors in order to determine a “complication prediction rule.” Here’s a look at four conditions that increased a person’s risk of complications after CSM surgery:

  • Diabetes
  • A condition called “ossification of the posterior longitudinal ligament, where the ligament connecting the bones of the spine becomes calcified, which leads to spinal cord compression.
  • Those who had longer surgeries or two-stage operations.
  • The overall number of other medical issues, like heart disease of high blood pressure.

“Although surgery is generally safe and effective, complications still occur in 11 to 38 percent of patients,” Dr. Fehlings and colleagues wrote.

But, by having a better idea of which patients are at an elevated risk for complications, surgeons can better anticipate these complications, take preventative measures and monitor patients more closely after surgery.

“Surgeons can use this information to discuss the risks and benefits of surgery with patients, to plan case-specific preventative strategies, and to ensure appropriate management in the perioperative period.”

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