Postoperative Delayed Cervical Palsies: Understanding the Etiology
| Autor: | Grant W. Mallory, Ryan Planchard, Jeremy L. Fogelson, Ross C. Puffer, Michelle J. Clarke, Patrick R. Maloney, William E. Krauss, Ahmad Nassr, Robert J. Spinner |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
etiology cervical spine postoperative C5 palsy inflammatory neuropathy 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Medicine Orthopedics and Sports Medicine Autoimmune disease 030222 orthopedics Univariate analysis Palsy business.industry autoimmune Odds ratio medicine.disease Confidence interval Surgery Etiology Original Article Neurology (clinical) business Complication 030217 neurology & neurosurgery |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5690 2192-5682 |
| DOI: | 10.1055/s-0035-1570084 |
| Popis: | Study Design Retrospective study. Objective This study reviews 1,768 consecutive cervical decompressions with or without instrumented fusion to identify patient-specific and procedural risk factors significantly correlated with the development of delayed cervical palsy (DCP). Methods Baseline demographic and procedural information was collected from the electronic medical record. Particular attention was devoted to reviewing each chart for recognized risk factors of postsurgical inflammatory neuropathy: autoimmune disease, blood transfusions, diabetes, and smoking. Results Of 1,669 patients, 56 (3.4%) developed a DCP. Although 71% of the palsies involved C5, 55% of palsies were multimyotomal and 18% were bilateral. Significant risk factors on univariate analysis included age ( p = 0.0061, odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.008 to 1.050), posterior instrumented fusion ( p Conclusions Although this study partially supports a mechanical etiology in the pathogenesis of a DCP, we also describe a notable correlation with autoimmune risk factors. Bilateral and multimyotomal involvement provides additional support that some DCPs may result from an inflammatory response and thus an underlying multifactorial etiology for this complication. |
| Databáze: | OpenAIRE |
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