Clinical and Surgical Predictors of Specific Complications following Surgery for the Treatment of Degenerative Cervical Myelopathy: Results from the Multicenter, Prospective AOSpine International Study on 479 Patients

Introduction This study aimed to identify important clinical and surgical predictors of perioperative complications in patients with CSM. This knowledge will help clinicians recognize their high-risk patients and allow them to institute appropriate prevention plans.Material and Methods This study aimed to identify important clinical and surgical predictors of perioperative complications in patients with CSM. This knowledge will help clinicians recognize their high-risk patients and allow them to institute appropriate prevention plans.Results A total of 80 patients experienced 92 perioperative complications (16.7%). Univariately, the major clinical risk factors were OPLL (p= 0.022), the number of comorbidities (p= 0.020), diabetes (p= 0.004), and coexisting gastrointestinal disorders (p= 0.045). Patients undergoing a two-stage surgery and those with a longer operative duration were also at a greater risk of perioperative complications. A final model consisted of diabetes (OR = 2.35, p= 0.039), age (OR = 1.02, 0.25), operative duration (OR = 1.003, p= 0.17), two-stage surgery (OR = 20.37, p= 0.012), OPLL (OR = 1.82, p= 0.064), gastrointestinal comorbidities (OR = 2.53, p= 0.020), and BMI (OR = 1.06,p= 0.10).Conclusion Patients are at a higher risk of perioperative complications if they are older; have OPLL, a higher BMI, diabetes or gastrointestinal disorders; and if they undergo a two-stage surgery and a long operation.