Our Summary

This research paper set out to identify the risk factors that could lead to complications after spinal surgery for spinal stenosis (narrowing of the spaces within your spine) in Japanese patients. The study looked at patients who had spinal surgery between 2008 and 2012, and collected data on complications that occurred within 30 days of the surgery.

There were 364 patients who underwent a total of 407 spinal surgeries. These surgeries took place in different parts of the spine: the neck (cervical), upper back (thoracic), and lower back (lumbar). The most common reason for surgery in the thoracic area was thickening of a specific ligament in the spine. Meanwhile, for the cervical and lumbar areas, the most common reasons were degenerative stenosis (wearing down of the spine) and disc herniation (bulging of a disc in the spine).

The two most common types of surgery performed were laminoplasty (creating more space for the spinal cord by reshaping the vertebrae) and laminectomy (removing part of the vertebral bone).

The results showed that complications were more likely in patients who had surgery in the thoracic area (36%) compared to those who had surgery in the cervical (16%) or lumbar area (13%). After further analysis, it was found that having stenosis in the thoracic area was the only independent risk factor for complications after surgery.

The study suggests that the location of the stenosis in the spine significantly affects the risk of complications after surgery. This could be due to the fact that hardened lesions, which are often the cause of thoracic stenosis, are difficult to operate on. This finding is particularly relevant in East Asia, where such conditions are common.

FAQs

  1. What were the most common diagnoses in patients with cervical, thoracic, and lumbar stenosis who underwent spinal surgery?
  2. What were the most frequently performed procedures on patients with spinal stenosis?
  3. Based on the study, what is the risk factor for complications after a spinal surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal decompression is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow the spine to properly heal. It is also important to attend all follow-up appointments and communicate any unusual symptoms or concerns to the healthcare provider. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support the healing process and prevent future spinal issues.

Suitable For

Patients with thoracic spinal stenosis, particularly those with challenging ossified lesions, are typically recommended spinal decompression surgery. These patients have a higher risk of perioperative complications compared to patients with cervical or lumbar stenosis. Other risk factors for complications include older age, presence of comorbidities, and the specific type of surgical procedure performed. It is important for healthcare providers to carefully assess the individual patient’s condition and risk factors before recommending spinal decompression surgery.

Timeline

Before spinal decompression:

  • Patient experiences symptoms such as pain, numbness, tingling, or weakness in the affected area
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis of spinal stenosis
  • Patient consults with a spine specialist to discuss treatment options, including spinal decompression surgery

After spinal decompression:

  • Patient undergoes spinal decompression surgery, which may involve laminectomy or laminoplasty
  • Patient may experience some pain and discomfort immediately after surgery
  • Patient undergoes physical therapy and rehabilitation to strengthen the muscles supporting the spine
  • Patient gradually experiences relief from symptoms and improved mobility as the spine heals
  • Patient follows up with the spine specialist for post-operative care and monitoring of the surgical site.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal decompression surgery?
  2. How long is the recovery period after spinal decompression surgery?
  3. What type of anesthesia will be used during the procedure?
  4. What is the success rate of spinal decompression surgery for my specific condition?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. Are there any alternative treatments or procedures that could be considered instead of spinal decompression surgery?
  7. How many spinal decompression surgeries have you performed, and what is your success rate?
  8. What is the expected outcome or prognosis after spinal decompression surgery?
  9. Will I need to make any lifestyle changes or modifications after the surgery?
  10. Are there any specific precautions or restrictions I should be aware of following the surgery?

Reference

Authors: Takai K, Matsumoto T, Yabusaki H, Yokosuka J, Hatanaka R, Taniguchi M. Journal: J Clin Neurosci. 2016 Apr;26:110-5. doi: 10.1016/j.jocn.2015.06.029. Epub 2016 Jan 12. PMID: 26791473