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Identifying Factors for Predicting Postoperative Segmental Motor Paralysis in Patients Undergoing Anterior Cervical
Hiroaki Onuma1, Takashi Hirai1, Kenichiro Sakai2
1Department of Orthopedic Surgery, Institute of Science Tokyo, Tokyo, Japan.
Spine
|October 23, 2024
Summary
Segmental motor paralysis after anterior cervical spine surgery affects 6.9% of patients, particularly those with ossification of the posterior longitudinal ligament (OPLL) undergoing corpectomy. Most patients recover, but prevention is crucial for high-risk individuals.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Surgery
Background:
- Segmental motor paralysis is a known complication of cervical decompression surgery.
- Previous studies on risk factors after anterior cervical spine surgery had small sample sizes.
- Larger investigations are needed to understand the pathogenesis and risk factors.
Purpose of the Study:
- To determine the incidence of segmental motor paralysis after anterior cervical spine surgery.
- To identify associated risk factors for this complication.
- To analyze clinical outcomes and recovery patterns.
Main Methods:
- Retrospective cohort study of 1428 patients undergoing anterior cervical spine surgery.
- Analysis of clinico-demographic and operative factors.
- Statistical analysis (univariate and multivariate) to identify risk factors.
Main Results:
- The incidence of segmental motor paralysis was 6.9% (99/1428 patients), primarily affecting the C5 segment.
- Ossification of the posterior longitudinal ligament (OPLL) and anterior cervical corpectomy were associated with higher incidence.
- Independent risk factors included older age, male sex, higher BMI, OPLL, and cervical corpectomy.
Conclusions:
- Clinico-demographic and operative factors significantly influence the risk of segmental motor paralysis.
- Patients undergoing corpectomy, especially with OPLL, face a high risk.
- While most patients achieve recovery, the complication can lead to worse long-term outcomes, emphasizing the need for preventative strategies.
