Spine Research Fellow University at Buffalo Neurosurgery (UBNS) University at Buffalo Neurosurgery (UBNS) Buffalo, NY, US
Disclosure(s):
Jacob D. Greisman, MD: No financial relationships to disclose
Introduction: Cervical spinal deformity surgery is intricate and often linked with various complications. It's crucial to ascertain the primary risk factors associated with these complications to optimize patient care and surgical outcomes.
Methods: Identify the primary risk factors associated with postoperative complications, encompassing overall complications and the necessity for reoperation, after cervical spine deformity surgery.
Results: In the analysis, a total of 144 patients were included, with 34 (23.6%) experiencing complications. There were no statistically significant differences between the complication and non-complication groups in terms of age (70.29±13.4 vs. 70.13±13.7, p=0.95) or the number of instrumented levels (8.21±1.68 vs. 8.09±2.06, p=0.743). However, the CD-F1 frailty index was notably different between the groups, with the complication group exhibiting a higher value (0.26±0.13 vs. 0.2±0.14, p=0.045).
Patients with complications had a higher incidence of any degree of leg weakness identified during medical examination (73.5% vs. 45.8%, p< 0.005), a higher prevalence of preoperative restricted activity level (76.4% vs. 57.3%, p=0.044), and a higher frequency of multiple medical comorbidities (70.5% vs. 50%, p=0.035). Binary logistic regression analysis revealed that preoperative weakness in the lower limbs was significantly associated with an odds ratio of 7.16 (95% CI 1.4-36.6, p=0.018) for overall surgical and medical complications following cervical adult spinal deformity surgery.
Conclusion : Patients undergoing correction surgery for cervical deformities should be thoroughly informed about the increased odds—7.5 times higher—of experiencing poorer clinical outcomes if they exhibit preoperative weakness in the lower limbs.