Neurospine.  2019 Sep;16(3):548-557. 10.14245/ns.1938198.099.

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 RK
• Chan AK
• Rivera J
• Molinaro A
• Doherty BR
• Riew KD
• Chou D
• Mummaneni
• Tan LA

• KMID: 2463575
• DOI: http://doi.org/10.14245/ns.1938198.099

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

MeSH Terms

Adult
Cohort Studies
Counseling
Humans
Incidence
Laminectomy*
Logistic Models
Multivariate Analysis
Narcotics
Operative Time
Protective Factors
Retrospective Studies
Risk Factors*
Surgeons
Walking*
Narcotics