title: Surgical complications associated with spinal decompression surgery in a Japanese cohort.
abstract: The aim of the present study was to identify risk factors for perioperative complications associated with spinal surgery for cervical, thoracic, and lumber spinal stenosis in a Japanese cohort. Patients with spinal stenosis who underwent spinal surgery between 2008 and 2012 were included. Neurological and/or surgical site complications within 30 days of index surgery were retrospectively collected, and the rates of complications were calculated. Using univariate and multivariate logistic regression analyses, risk factors for complications were identified. A total of 364 patients underwent 407 spinal surgeries. Of the 407 surgeries performed, 236 were cervical, 28 were thoracic, and 143 were lumbar surgeries. Ossification of the ligamentum flavum was the most common diagnosis in patients with thoracic stenosis (85%), whereas spinal degenerative stenosis and disc herniation were the two most common diagnoses in patients with cervical and lumbar stenosis. Laminoplasty and laminectomy alone were the two most frequently performed procedures. The rate of complications was greater in patients with thoracic stenosis (36%) than in those with cervical (16%) or lumbar stenosis (13%, p=0.013). After a multivariate analysis, only thoracic stenosis (odds ratio 2.87) remained an independent risk factor for surgical complications. The novel result of the present study was that the level of stenosis in the spine had a significant impact on complications after spinal surgery in a Japanese cohort. The result can be explained by the fact that challenging ossified lesions are a common cause of thoracic stenosis in eastern Asia.
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan. Electronic address: takai-nsu@umin.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takai
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yabusaki
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yokosuka
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Hatanaka
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo 183-0042, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Taniguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000639:trends; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007796:Laminectomy / Q000009:adverse effects / Q000639:trends; D017843:Ligamentum Flavum / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery
keywords: Adverse effects; Laminectomy; Laminoplasty; Multivariate analysis; Outcome; Postoperative complications