A simple model consisting of four risk factors can help surgeons to predict the risk of complications after surgery for cervical spondylotic myelopathy (CSM), reports a study in the July issue of Neurosurgery, official journal of the Congress of Neurological Surgeons.
The presence of other medical conditions, particularly diabetes, is among the factors associated with a higher risk of complications, according to the report by Michael G. Fehlings of Toronto Western Hospital and colleagues.
Clinical and Surgical Factors Predict Complications after Surgery for CSM
Patients with CSM have neck pain and stiffness, and sometimes numbness and weakness in the arms and legs, caused by pressure on either the spinal cord or major nerve roots. Patients with persistent or severe symptoms may need surgery, which carries a small but definite risk of complications.
Fehlings and colleagues analysed data on 479 patients who underwent surgery for CSM as part of an international study. They identified a total of 89 surgery-related complications in 78 patients — a rate of 16.25 per cent.
The researchers compared a wide range of clinical and surgical factors for patients with and without surgery. These factors were then incorporated into a “complication prediction rule” to identify those factors associated with an increased risk of complications related to CSM surgery.
Factors related to an increased risk of complications included a condition called “ossification of the posterior longitudinal ligament” (OPLL), where the ligament connecting the bones of the spine becomes calcified, causing compression of the spinal co