An Assessment of the Key Predictors of Perioperative Complications in Patients with Cervical Spondylotic Myelopathy Undergoing Surgical Treatment: Results from a Survey of 916 AOSpine International Members (original) (raw)

World Neurosurgery, 2015

Abstract

Surgery for the treatment of cervical spondylotic myelopathy (CSM) is typically accompanied by complication rates between 11% and 38%. By determining clinical and surgical predictors of complications, clinicians can identify high-risk patients and plan accordingly. This study aims to conduct a survey of the AOSpine community to identify key predictors of postoperative complications. Members of AOSpine International were invited participate. The survey was divided into three sections. The first and second sections focused on key clinical and imaging risk factors. The third section was designed to determine whether rates of complications differ depending on surgical approach, procedure, number of stages and use of fusion. Results from the entire sample and from each geographic region were analyzed. Nine-hundred and sixteen participants completed the survey. The presence of co-morbidities was ranked as the most important clinical predictor of complications. The majority of respondents believed that patients with diabetes are at a higher risk of cardiac complications (69.75%) and wound infections (95.0%) than non-diabetics. Regarding surgical technique, 40% of professionals reported higher complication rates in posterior compared to anterior surgery, while 30% believed there is no difference. The types of complications vary significantly between approaches. On the other hand, rates of dysphagia, wound infection, dural tear and C5 radiculopathy are similar between posterior techniques. This survey summarizes surgeons' perceptions of the most important clinical, imaging and surgical risk factors for postoperative complications. Knowledge of these predictors will allow clinicians to identify high-risk patients and the institution of prevention plans.

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