Leanne Tan, Daniel Loh, Wayne Ming Quan Yap, Arun-Kumar Kaliya-Perumal, Ji Min Ling, Lester Lee, Colum Nolan, Jacob Yoong-Leong Oh
{"title":"颈椎后路融合术后假体相关并发症的发生频率及预测因素。","authors":"Leanne Tan, Daniel Loh, Wayne Ming Quan Yap, Arun-Kumar Kaliya-Perumal, Ji Min Ling, Lester Lee, Colum Nolan, Jacob Yoong-Leong Oh","doi":"10.1080/02688697.2023.2239899","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, observational study.</p><p><strong>Purpose: </strong>To determine the frequency and predictors of implant-related complications in adults after posterior cervical fusion.</p><p><strong>Overview of literature: </strong>Published literature on lumbosacral fusion suggest that implant-related complications are not uncommon. Although posterior cervical fusion is a common operation, data on frequency and predictors of implant-related complications after posterior cervical fusion is still scarce.</p><p><strong>Methods: </strong>86 patients (with 740 screws) who underwent posterior cervical fusion were included. Implant-related complications were identified by the presence of: (1) halo sign, (2) screw pull-out/breakage (3) post-operative kyphosis and (4) implant-related complications requiring revision surgery. These were stratified into two groups: (a) minor - isolated halo sign or screw pull-out/breakage (b) major - post-operative kyphosis > 10 degrees, and revision surgery. Demographic, operative and radiological data was collected. Rates of implant-related complications were determined and associated risk factors identified.</p><p><strong>Results: </strong>33 (38.4%) patients had signs of implant-related complications. Of these, 29 (87.9%) had minor complications and 4 (12.1%) had major complications. Charlson Comorbidity Index (CCI) (<i>p</i> = 0.03179) and pre-op C2-C7 sagittal vertical alignment (SVA) (<i>p</i> = 0.02449) were the only significant risk factors for all-cause implant-related complications during multivariate logistic regression. Other intraoperative parameters (type of screw, length of fusion, levels decompressed, and extension of fusion beyond the levels decompressed) were not significantly associated with implant-related complications.</p><p><strong>Conclusions: </strong>Implant-related complications are not uncommon but rarely require revision surgery. Higher pre-operative SVA and CCI were significant risk factors; length of construct and extent of decompression were not. These findings may assist clinicians when deciding the extent of fusion and in selecting patients for closer follow-up.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"312-319"},"PeriodicalIF":1.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frequency and predictors of implant-related complications after posterior cervical fusion.\",\"authors\":\"Leanne Tan, Daniel Loh, Wayne Ming Quan Yap, Arun-Kumar Kaliya-Perumal, Ji Min Ling, Lester Lee, Colum Nolan, Jacob Yoong-Leong Oh\",\"doi\":\"10.1080/02688697.2023.2239899\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective, observational study.</p><p><strong>Purpose: </strong>To determine the frequency and predictors of implant-related complications in adults after posterior cervical fusion.</p><p><strong>Overview of literature: </strong>Published literature on lumbosacral fusion suggest that implant-related complications are not uncommon. Although posterior cervical fusion is a common operation, data on frequency and predictors of implant-related complications after posterior cervical fusion is still scarce.</p><p><strong>Methods: </strong>86 patients (with 740 screws) who underwent posterior cervical fusion were included. Implant-related complications were identified by the presence of: (1) halo sign, (2) screw pull-out/breakage (3) post-operative kyphosis and (4) implant-related complications requiring revision surgery. These were stratified into two groups: (a) minor - isolated halo sign or screw pull-out/breakage (b) major - post-operative kyphosis > 10 degrees, and revision surgery. Demographic, operative and radiological data was collected. Rates of implant-related complications were determined and associated risk factors identified.</p><p><strong>Results: </strong>33 (38.4%) patients had signs of implant-related complications. Of these, 29 (87.9%) had minor complications and 4 (12.1%) had major complications. Charlson Comorbidity Index (CCI) (<i>p</i> = 0.03179) and pre-op C2-C7 sagittal vertical alignment (SVA) (<i>p</i> = 0.02449) were the only significant risk factors for all-cause implant-related complications during multivariate logistic regression. Other intraoperative parameters (type of screw, length of fusion, levels decompressed, and extension of fusion beyond the levels decompressed) were not significantly associated with implant-related complications.</p><p><strong>Conclusions: </strong>Implant-related complications are not uncommon but rarely require revision surgery. Higher pre-operative SVA and CCI were significant risk factors; length of construct and extent of decompression were not. These findings may assist clinicians when deciding the extent of fusion and in selecting patients for closer follow-up.</p>\",\"PeriodicalId\":9261,\"journal\":{\"name\":\"British Journal of Neurosurgery\",\"volume\":\" \",\"pages\":\"312-319\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02688697.2023.2239899\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02688697.2023.2239899","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Frequency and predictors of implant-related complications after posterior cervical fusion.
Study design: Retrospective, observational study.
Purpose: To determine the frequency and predictors of implant-related complications in adults after posterior cervical fusion.
Overview of literature: Published literature on lumbosacral fusion suggest that implant-related complications are not uncommon. Although posterior cervical fusion is a common operation, data on frequency and predictors of implant-related complications after posterior cervical fusion is still scarce.
Methods: 86 patients (with 740 screws) who underwent posterior cervical fusion were included. Implant-related complications were identified by the presence of: (1) halo sign, (2) screw pull-out/breakage (3) post-operative kyphosis and (4) implant-related complications requiring revision surgery. These were stratified into two groups: (a) minor - isolated halo sign or screw pull-out/breakage (b) major - post-operative kyphosis > 10 degrees, and revision surgery. Demographic, operative and radiological data was collected. Rates of implant-related complications were determined and associated risk factors identified.
Results: 33 (38.4%) patients had signs of implant-related complications. Of these, 29 (87.9%) had minor complications and 4 (12.1%) had major complications. Charlson Comorbidity Index (CCI) (p = 0.03179) and pre-op C2-C7 sagittal vertical alignment (SVA) (p = 0.02449) were the only significant risk factors for all-cause implant-related complications during multivariate logistic regression. Other intraoperative parameters (type of screw, length of fusion, levels decompressed, and extension of fusion beyond the levels decompressed) were not significantly associated with implant-related complications.
Conclusions: Implant-related complications are not uncommon but rarely require revision surgery. Higher pre-operative SVA and CCI were significant risk factors; length of construct and extent of decompression were not. These findings may assist clinicians when deciding the extent of fusion and in selecting patients for closer follow-up.
期刊介绍：
The British Journal of Neurosurgery is a leading international forum for debate in the field of neurosurgery, publishing original peer-reviewed articles of the highest quality, along with comment and correspondence on all topics of current interest to neurosurgeons worldwide.
Coverage includes all aspects of case assessment and surgical practice, as well as wide-ranging research, with an emphasis on clinical rather than experimental material. Special emphasis is placed on postgraduate education with review articles on basic neurosciences and on the theory behind advances in techniques, investigation and clinical management. All papers are submitted to rigorous and independent peer-review, ensuring the journal’s wide citation and its appearance in the major abstracting and indexing services.
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