Risk factors for delayed extubation in the management of severe ossification of the posterior longitudinal ligament in the cervical spine (Ossified Posterior Longitudinal ligament) laminectomy

Sapna Annaji Nikhar; Dilip Kumar Kulkarni; R. Gopinath

Volume : VI, Issue : VII, July - 2017

Risk factors for delayed extubation in the management of severe ossification of the posterior longitudinal ligament in the cervical spine (Ossified Posterior Longitudinal ligament) laminectomy

Sapna Annaji Nikhar, Dilip Kumar Kulkarni, R. Gopinath

Abstract :

Objective. To identify the risk factors for a delayed extubation after cervical spine surgery for cervical OPLL in posterior approach.

Background Data: Though the airway and surgery related complications are documented in cervical spine surgery, patients occasionally require prolonged mechanical ventilation or an unplanned reintubation for airway support if proper planning and extubation done in over 24 hrs postop–period in planned manner. Despite the potential severity of these complications, there are limited data in the published literature addressing this issue. Multiple risk factors are correlated with postop airway problems in combined spinal surgery but specifically for posterior approach data is lacking.

Methods: 50 ASA( American Society of anaesthesiology) I to III patients posted electively for posterior approach surgery were only included. Different risk factors were recorded to assess extubation difficulty.

Results: Out of 50 patients, 14 had extubation difficulty. Duration of surgery and numbers of levels are main risk factors with odds ratio of 1.022 and 2.365 respectively. ASA classification, NYHA classification and preoperative neurological dysfunction are also among the major risk factors contributing for delayed extubation.

Conclusion: Duration of surgery and levels of spine involved are primary risk factors involved for difficult extubation.