Abstract
Study design
A retrospective chart review.
Objectives
Total en bloc spondylectomy (TES) has been reported to decrease the rate of local recurrence and increase survival. Although it is important to achieve early recovery of physical functions after surgery, no studies have evaluated rehabilitation outcomes during the acute phase after TES. This study evaluated ambulatory functions and activities of daily living (ADLs) after surgery and analyzed the prognostic significance of variables affecting rehabilitation outcomes at 1 month after TES.
Setting
University hospital in Kanazawa, Japan.
Methods
This study included 140 patients with spinal tumors who underwent TES between April 2010 and April 2017. Demographic characteristics, neurological functions, perioperative complications functional status as measured by the Functional Independent Measure, and independent indoor walking based on the Spinal Cord Independent Measure were extracted from medical records. Multivariate analyses were performed to assess factors associated with the recovery of ambulation and ADL at 1 month after TES.
Results
Preoperative neurological deficits were observed in 51 patients (36%), and postoperative neurological deterioration was found in 41 patients (29%). Multivariate analyses indicated that preoperative neurological deficits (odds ratio [OR], 5.23; 95% confidence interval [CI], 2.07–15.99), postoperative cerebrospinal fluid leakage (OR, 13.42; 95% CI, 2.93–78.82), surgical site infections (OR, 15.27; 95% CI, 2.26–127.7), and postoperative neurological deterioration (OR, 4.86; 95% CI, 1.33–19.99) were risk factors for walking ability and recovery of ADL (P < 0.01).
Conclusions
This study identified preoperative neurological dysfunction and perioperative complications as independent risk factors for poor recovery of ambulation and ADL early after TES.
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Acknowledgements
We would like to thank Editage (www.editage.jp) for English language editing.
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YK was responsible for designing the review protocol, conducting the search, screening potentially eligible studies, extracting and analyzing data, interpreting results, creating tables, creating figures, and writing the report. HM and SD were responsible for designing the review protocol, screening potentially eligible studies, and extracting and analyzing data, and interpreting results. SK contributed to writing the report, extracting and analyzing data, interpreting results, and providing feedback regarding the report. NY, KS, TS, and HT contributed to data extraction and provided feedback regarding the report.
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This study was approved by the ethics committee of our University Hospital.
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Kurokawa, Y., Murakami, H., Demura, S. et al. Risk factors for poor outcomes of early rehabilitation after total en bloc spondylectomy: a retrospective chart review of 140 patients. Spinal Cord 58, 900–907 (2020). https://doi.org/10.1038/s41393-020-0440-8
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DOI: https://doi.org/10.1038/s41393-020-0440-8
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