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Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy

INTRODUCTION: Due to the narrow portal of entry, microendoscopic laminectomy (MEL) is associated with a risk of postoperative spinal epidural hematoma (POSEH). This risk might be higher when performing multiple-level (m-) MEL. The purpose of this study is to clarify the incidence rate of POSEH follo...

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Autores principales: Bekki, Hirofumi, Arizono, Takeshi, Inokuchi, Akihiko, Imamura, Ryuta, Hamada, Takahiro, Oyama, Ryunosuke, Hyodo, Yuki, Kinoshita, Eiji, Kido, Mariko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society for Spine Surgery and Related Research 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842358/
https://www.ncbi.nlm.nih.gov/pubmed/35224246
http://dx.doi.org/10.22603/ssrr.2021-0025
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author Bekki, Hirofumi
Arizono, Takeshi
Inokuchi, Akihiko
Imamura, Ryuta
Hamada, Takahiro
Oyama, Ryunosuke
Hyodo, Yuki
Kinoshita, Eiji
Kido, Mariko
author_facet Bekki, Hirofumi
Arizono, Takeshi
Inokuchi, Akihiko
Imamura, Ryuta
Hamada, Takahiro
Oyama, Ryunosuke
Hyodo, Yuki
Kinoshita, Eiji
Kido, Mariko
author_sort Bekki, Hirofumi
collection PubMed
description INTRODUCTION: Due to the narrow portal of entry, microendoscopic laminectomy (MEL) is associated with a risk of postoperative spinal epidural hematoma (POSEH). This risk might be higher when performing multiple-level (m-) MEL. The purpose of this study is to clarify the incidence rate of POSEH following single-level (s-) and m-MEL by each interlaminar level and identify the risk factors for POSEH following m-MEL. METHODS: A total of 379 patients underwent MEL of the lumbar spine (s-MEL, n=141; m-MEL, n=238). We determined the incidence of POSEH following s-MEL and m-MEL by each interlaminar level. For m-MEL, we clarified the correlation between POSEH and possible risk factors, such as operative findings, the sequence of operated interlaminar levels, and the preoperative cross-sectional dural area (CSA) on magnetic resonance imaging. RESULTS: The incidence rate at L2/3 was significantly higher than that at L3/4 and L4/5. Patients who underwent L2/3 decompression at the end of the procedure showed a higher incidence of POSEH at the L2/3 level. Preoperative spinal stenosis was associated with POSEH at the L2/3 level, and CSA of 56 mm(2) was a predictive factor for POSEH. Logistic regression analysis revealed that both were significant risk factors. CONCLUSIONS: In patients undergoing m-MEL, the incidence of POSEH is highest at the L2/3 level, and treatment of the L2/3 level at the end of the procedure and the presence of spinal stenosis are risk factors for POSEH.
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spelling pubmed-88423582022-02-25 Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy Bekki, Hirofumi Arizono, Takeshi Inokuchi, Akihiko Imamura, Ryuta Hamada, Takahiro Oyama, Ryunosuke Hyodo, Yuki Kinoshita, Eiji Kido, Mariko Spine Surg Relat Res Original Article INTRODUCTION: Due to the narrow portal of entry, microendoscopic laminectomy (MEL) is associated with a risk of postoperative spinal epidural hematoma (POSEH). This risk might be higher when performing multiple-level (m-) MEL. The purpose of this study is to clarify the incidence rate of POSEH following single-level (s-) and m-MEL by each interlaminar level and identify the risk factors for POSEH following m-MEL. METHODS: A total of 379 patients underwent MEL of the lumbar spine (s-MEL, n=141; m-MEL, n=238). We determined the incidence of POSEH following s-MEL and m-MEL by each interlaminar level. For m-MEL, we clarified the correlation between POSEH and possible risk factors, such as operative findings, the sequence of operated interlaminar levels, and the preoperative cross-sectional dural area (CSA) on magnetic resonance imaging. RESULTS: The incidence rate at L2/3 was significantly higher than that at L3/4 and L4/5. Patients who underwent L2/3 decompression at the end of the procedure showed a higher incidence of POSEH at the L2/3 level. Preoperative spinal stenosis was associated with POSEH at the L2/3 level, and CSA of 56 mm(2) was a predictive factor for POSEH. Logistic regression analysis revealed that both were significant risk factors. CONCLUSIONS: In patients undergoing m-MEL, the incidence of POSEH is highest at the L2/3 level, and treatment of the L2/3 level at the end of the procedure and the presence of spinal stenosis are risk factors for POSEH. The Japanese Society for Spine Surgery and Related Research 2021-06-11 /pmc/articles/PMC8842358/ /pubmed/35224246 http://dx.doi.org/10.22603/ssrr.2021-0025 Text en Copyright © 2022 by The Japanese Society for Spine Surgery and Related Research https://creativecommons.org/licenses/by-nc-nd/4.0/Spine Surgery and Related Research is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Bekki, Hirofumi
Arizono, Takeshi
Inokuchi, Akihiko
Imamura, Ryuta
Hamada, Takahiro
Oyama, Ryunosuke
Hyodo, Yuki
Kinoshita, Eiji
Kido, Mariko
Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title_full Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title_fullStr Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title_full_unstemmed Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title_short Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy
title_sort risk factors for incidence of postoperative spinal epidural hematoma following multilevel microendoscopic laminectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842358/
https://www.ncbi.nlm.nih.gov/pubmed/35224246
http://dx.doi.org/10.22603/ssrr.2021-0025
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