Perioperative complications of anterior cervical decompression with fusion in patients with ossification of the posterior longitudinal ligament: a retrospective, multi-institutional study
| Autor: | Atsushi Ono, Masashi Yamazaki, Takui Ito, Yoshiaki Toyama, Masahiko Watanabe, Takashi Kaito, Atsushi Kimura, Shinnosuke Nakahara, Kenji Endo, Masahito Takahashi, Yukihiro Nakagawa, Yuichi Hoshino, Kuniyoshi Abumi, Kenzo Uchida, Toshihiko Taguchi, Kei Miyamoto, Atsushi Seichi, Tsuyoshi Kato, Masashi Neo, Takahito Fujimori, Shinichirou Taniguchi, Kei Yamada, Macondo Mochizuki, Atsuomi Aiba, Hirotaka Chikuda |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Decompression medicine.medical_treatment macromolecular substances Ossification of Posterior Longitudinal Ligament Myelopathy Internal medicine medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over business.industry Incidence Retrospective cohort study Perioperative Middle Aged Decompression Surgical medicine.disease Laminoplasty Rheumatology Surgery Paresis Spinal Fusion Treatment Outcome medicine.anatomical_structure Orthopedic surgery Cervical Vertebrae Female business Spinal Cord Compression Cervical vertebrae |
| Zdroj: | Journal of Orthopaedic Science. 17:667-672 |
| ISSN: | 0949-2658 |
| Popis: | Anterior decompression with fusion (ADF) for patients with cervical ossification of the posterior longitudinal ligament (OPLL) is reportedly associated with a higher incidence of complications than is laminoplasty. However, the frequency of perioperative complications associated with ADF for cervical OPLL has not been fully established. The purpose of this study was to investigate the incidence of perioperative complications, especially neurological complications, following ADF performed to relieve compressive cervical myelopathy due to cervical OPLL.Study participants comprised 150 patients who had undergone ADF for cervical OPLL at 27 institutions between 2005 and 2008. Perioperative--especially neurological--complications occurring within 2 weeks after ADF were analyzed. Preoperative imaging findings, including Cobb angle, between C2 and C7 and occupying ratio of OPLL were investigated. Multivariate analysis with logistic regression was performed to identify independent risk factors for neurological complications.Three patients (2.0 %) showed deterioration of lower-extremity function after ADF. One of the three patients had not regained their preoperative level of function 6 months after surgery. Upper-extremity paresis occurred in 20 patients (13.3 %), five of whom had not returned to preoperative levels 6 months after surgery. Patients with upper-extremity paresis showed significantly higher occupying ratios of OPLL, greater blood loss, longer operation times, fusion of more segments, and higher rates of cerebrospinal fluid leakage than those without paresis. Independent risk factors for upper-extremity paresis were a high occupying ratio of OPLL and large blood loss during surgery.The incidences of deterioration in upper- and lower-extremity functions were 13.3 % and 2.0 %, respectively. Patients with a high occupying ratio of OPLL are at higher risk of developing neurological deterioration. |
| Databáze: | OpenAIRE |
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