Complications following posterior cervical decompression and fusion: a review of incidence, risk factors, and prevention strategies

Badiee, Ryan K; Mayer, Rory R.; Pennicooke, Brenton; Chou, Dean; Mummaneni, Praveen V.; Tan, Lee A.

doi:10.21037/jss.2019.11.01

Cited by 66 publications

(77 citation statements)

References 57 publications

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“…The overall neurological complications of posterior approach cervical surgery were estimated to range from about 15% to 25% in the current literature. [ 10 ] Chiropractic manipulation in this regard seems to be far safer than pharmacological or surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Alleviating cervical radiculopathy by manipulative correction of reversed cervical lordosis

Chu

2021

Journal of Family Medicine and Primary Care

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Cervical radiculopathy is a neurologic condition caused by nerve root compression in the cervical spine, resulting in pain, numbness, sensory or motor dysfunction in the upper extremities. We present the case of a 57-year-old woman working as an insurance agent who suffered from chronic neck pain and numbness in the left arm for six months. Cervical radiographs revealed a reverse in natural lordotic curve. The patient was diagnosed with left C6 radiculopathy due to cervical spondylosis. Since cervical traction, rehabilitative exercise, acupuncture, and pain medicines previously failed to provide a long-lasting relief of symptoms, the patient sought chiropractic care. She was treated with spinal manipulation in combination with intermittent motorized cervical traction for three months. As a result of care, the patient experienced complete relief of symptoms, full cervical mobility, and high WHO Quality of Life score. A restoration of cervical lordosis was demonstrated on the 4-year follow-up radiograph.

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Section: Discussionmentioning

confidence: 99%

Alleviating cervical radiculopathy by manipulative correction of reversed cervical lordosis

Chu

2021

Journal of Family Medicine and Primary Care

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“…The patient factors domain was designed to assess the overall risk profile of a patient for complications arising from spinal surgery and the duration that the patient has endured while waiting for surgical intervention. Patients’ comorbidities have been reported as risk factors for post-operative complications arising from a variety of spinal surgeries [ 32 – 35 ]. We used the American Society of Anaesthesiologists (ASA) classification, a well-validated simple tool, to assess the patients’ comorbidities.…”

Section: Discussionmentioning

confidence: 99%

A novel hospital capacity versus clinical justification triage score (CCTS) for prioritization of spinal surgeries in the “new normal state" of the COVID-19 pandemic

et al. 2021

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“…There is no consensus in the literature on the effect of smoking on postoperative outcomes of cervical spine surgery. Most studies suggest that smoking has been associated with poor postoperative outcomes in anterior cervical discectomy and fusion and has also been associated with poor surgical outcomes in posterior cervical decompression and fusion [18][19][20][21]. However, some studies suggest that smoking is an independent predictor of poor postoperative outcomes after posterior cervical decompression and fusion [22].…”

Section: Introductionmentioning

confidence: 99%

Influence of Preoperative Smoking Status on Clinical Outcomes of Laminoplasty in Patients With Degenerative Cervical Myelopathy: a Prospective Study

Liang

Duan

Chen

et al. 2021

Preprint

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Background: Smoking is considered to be a risk factor for poor clinical outcomes after anterior cervical decompression and fusion surgery. However, it is unclear whether the preoperative smoking status has similar effects on clinical outcomes after laminoplasty. The current research is carried out to determine whether smoking status before laminoplasty affects clinical outcomes in patients with degenerative cervical myelopathy (DCM). Methods: A series of consecutive patients undergoing laminoplasty to treat DCM at a single institution between April 2017 and April 2020 were included. The patients were divided into the following 3 groups: active smoking (AS), passive smoking (PS), and non-smoking (NS). The primary outcome was the recovery rate of JOA at the last follow-up. Secondary outcomes included JOACMEQ score and the NRS (Numerical rating scale) for neck and arm pain. Statistical analysis of among the three groups differences were performed with ANOVA, and multivariable regression analysis was undertaken to explore predictor variables.Result: A total of 158 consecutive patients completed at least 6 months of follow-up. There were 108 men and 50 women. The mean (±standard deviation) age of this series was 57.7 ± 11.6 years. The average recovery rate of JOA, the improvement in the NRS for neck and arm pain, and in each domain of JOACMEQ did not differ significantly among the three groups (P＞0.05). When used 52.8% as the minimal clinically important difference (MCID) of the JOA recovery rate, active smokers (RR=0.950, 95%CI=0.740-1.220) and passive smokers (RR=0.830, 95%CI=0.540-1.277) had similar likelihoods of reaching MCID compared with non-smokers. Logistic regression revealed that age (OR=0.95, 95%CI=0.92-0.98, P=0.001) and preoperative JOA (OR=0.85, 95%CI=0.75-0.95, P=0.004) were risk factors of the recovery rate that did not reach MCID, but smoking status: AS (OR=0.56, 95%CI=0.21-1.47,P=0.24), PS (OR=.087, 95%CI=0.43-1.76, P=0.70), did not affect the clinical outcomes.Conclusion: Over a follow-up period of at least 6 months, active smokers, passive smokers, and non-smokers had similar improvements in clinical outcomes after laminoplasty. Thus, smoking status was not found to be an independent predictor of clinical outcomes after laminoplasty.

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Complications following posterior cervical decompression and fusion: a review of incidence, risk factors, and prevention strategies

Cited by 66 publications

References 57 publications

Alleviating cervical radiculopathy by manipulative correction of reversed cervical lordosis

Alleviating cervical radiculopathy by manipulative correction of reversed cervical lordosis

A novel hospital capacity versus clinical justification triage score (CCTS) for prioritization of spinal surgeries in the “new normal state" of the COVID-19 pandemic

Influence of Preoperative Smoking Status on Clinical Outcomes of Laminoplasty in Patients With Degenerative Cervical Myelopathy: a Prospective Study

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