Faculty Collaboration Database

Clinical adjacent-segment pathology after central corpectomy for cervical spondylotic myelopathy: incidence and risk factors. Neurosurg Focus 2016 Jun;40(6):E12

Date

06/02/2016

Pubmed ID

27246482

DOI

10.3171/2016.2.FOCUS1626

Scopus ID

2-s2.0-84975247370 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVE The goal of this study was to investigate the prevalence and risk factors of clinical adjacent-segment pathology (CASP) following central corpectomy for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL). METHODS The authors reviewed 353 cases involving patients operated on by a single surgeon with a minimum 12-month follow-up after central corpectomy for CSM or OPLL between 1995 and 2007. Patients with symptoms consistent with CASP at follow-up were selected for the study. The authors analyzed the prevalence and risk factors for CASP after central corpectomy for CSM/OPLL. RESULTS Fourteen patients (13 male, 1 female; mean age 46.9 ± 7.7 years) were diagnosed with symptoms of CASP (3.9% of 353 patients) at follow-up. The mean interval between the initial surgery and presentation with symptoms of CASP was 95.6 ± 54.1 months (range 40-213 months). Preoperative Nurick grades ranged from 2 to 5 (mean 3.5 ± 1.2), and the Nurick grades at follow-up ranged from 1 to 5 (mean 3.0 ± 1.3, p = 0.27). Twelve patients had myelopathic symptoms and 2 had radiculopathy at follow-up. Patients with poorer preoperative Nurick grades had a higher risk for development of CASP (HR 2.6 [95% CI 1.2-5.3], p = 0.01). CONCLUSIONS In the present study, CASP was seen in 3.9% of patients following central corpectomy for CSM/OPLL. The risk of CASP after central corpectomy for CSM/OPLL was higher in patients with poorer preoperative Nurick grades.

Author List

Vedantam A, Rajshekhar V

Author

Aditya Vedantam MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cervical Vertebrae
Decompression, Surgical
Female
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Ossification of Posterior Longitudinal Ligament
Postoperative Complications
Proportional Hazards Models
Radiculopathy
Risk Factors
Spondylosis
Treatment Outcome