Age and Cervical Myelopathy Are Risk Factors for Problems After SurgeryHospital records are kept nationally in the United States every year. They keep track of the age, sex, diagnosis, and treatment of each patient. The Nationwide Inpatient Sample is one of those databases. The information collected is available for research purposes.
In this study, researchers used information collected over a 10-year period from 1992 to 2001. They looked at treatment and outcomes of patients with degenerative disease of the cervical spine (neck). Over 900,000 records met the criteria for the study and were included.
All patients in the study had cervical spine surgery. More than half were for a herniated disc. Another 20 per cent had a diagnosis of cervical spondylosis with myelopathy.
Spondylosis is the degeneration of the vertebral joints with the development of bone spurs. It occurs most often with aging. The joint changes cause the space between the two adjacent vertebrae to narrow. This puts pressure on the spinal nerves. Painful symptoms and changes in sensation or weakness from this condition are called myelopathy.
Problems after surgery were classified into one of four groups: 1) no complications, 2) total number of complications, 3) heart, lung, or blood vessel problems, and 4) local complications. Local complications included hematomas, accidental cuts, infection, or blood vessel problems.
Analysis of the data showed an overall complication rate of about four per cent. Older adults (at least 74-years old) had the greatest risk of complications during their hospital stay. There were more deaths in the group who had higher rates of complications.
More deaths occurred in patients who had a posterior fusion. And patients with cervical spondylosis and myelopathy had more problems after surgery compared to patients with a herniated disc.
The authors conclude that older age and a diagnosis of cervical myelopathy puts people at increased risk for complications and death. Fortunately the rates of complication are low for this procedure.
Marjorie C. Wang, MD, MPH, et al. Complications and Mortality Associated with Cervical Spine Surgery for Degenerative Disease in the United States. In Spine. February 1, 2007. Vol. 32. No. 3. Pp. 342-347.
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