Grant: Travel Awards - Institute Community Support

Introduction: There is a lack of data examining the effects of adverse events (AEs) after surgery for degenerative cervical myelopathy (DCM) on long-term outcomes for patients. DCM is a condition where progressive arthritis develops in the neck and causes spinal cord compression that can reduce quality of life, arm and leg function as well as the ability to walk and live independently. We aimed to assess whether the occurrence of perioperative AEs influences outcomes after surgery for DCM in a cohort of Canadian patients recruited from across the country. Methods: We analyzed data from 800 patients enrolled in the Canadian Spine Outcomes and Research Network multicenter study. A standardized tool was used to assess AEs during surgery and shortly afterwards. We assessed the clinical response to surgery (arm and leg function measured by a doctor) and patient-reported neck pain up to 2 years after surgery. We used statistical modeling technique to assess the influence of minor and major AEs on outcome measures over time. Results: There were 167 (20.9%) patients with minor AEs and 36 (4.5%) patients with major AEs. Overall, patients without complications had improvement in neck pain and neurological function at follow-up. The occurrence of major AEs was associated with increased neck pain after surgery and reduction neurological function. Occurrence of major AEs reduced the chances that a patient would achieve meaningful benefit from the surgery in the post-operative period. Furthermore, we showed that these results were consistent across male and female sex. Conclusion: Major AEs were associated with reduced functional gains and worse recovery trajectories for patients undergoing surgery for DCM. Occurrence of major AEs reduced the probability of our surgical goals for post-operative improvement. Both minor and major AEs significantly increased health resource utilization by reducing the proportion of discharges home and increasing length of stay.