Preoperative Narcotic Use, Impaired Ambulation Status, and Increased Intraoperative Blood Loss Are Independent Risk Factors for Complications Following Posterior Cervical Laminectomy and Fusion Surgery

Objective: This retrospective cohort study seeks to identify risk factors associated with complications following posterior cervical laminectomy and fusion (PCLF) surgery. Methods: Adults undergoing PCLF from 2012 through 2018 at a single center were identified. Demographic and radiographic data, surgical characteristics, and complication rates were compared. Multivariate logistic regression models identified independent predictors of complications following surgery. Results: A total of 196 patients met the inclusion criteria and were included in the study. The medical, surgical, and overall complication rates were 10.2%, 23.0%, and 29.1% respectively. Risk factors associated with medical complications in multivariate analysis included impaired ambulation status (odds ratio [OR] , 2.27; p = 0.02) and estimated blood loss over 500 mL (OR, 3.67; p = 0.02). Multivariate analysis revealed preoperative narcotic use (OR, 2.43; p = 0.02) and operative time (OR, 1.005; p = 0.03) as risk factors for surgical complication, whereas antidepressant use was a protective factor (OR, 0.21; p = 0.01). Overall complication was associated with preoperative narcotic use (OR, 1.97; p = 0.04) and higher intraoperative blood loss (OR, 1.0007; p = 0.03). Conclusion: Preoperative narcotic use and estimated blood loss predicted the incidence of complications following PCLF for CSM. Ambulation status was a significant predictor of the development of a medical complication specifically. These results may help surgeons in counseling patients who may be at increased risk of complication following surgery.