{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:42:19Z","timestamp":1793464939634,"version":"4.5.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective multicenter cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence and risk factors for postoperative complications following cervical spine surgery and to explore their association with long-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1482 patients with degenerative cervical disorders who underwent surgery at 10 high-volume institutions in Japan were prospectively enrolled. Perioperative complications were defined as events occurring within 30 days postoperatively. Risk factors were analyzed using univariate and logistic regression analyses. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association (JOA) score and the Physical Component Summary (PCS) of the SF-36 at baseline and 2\u00a0years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Perioperative complications occurred in 5.5% of patients: segmental motor paralysis (2.3%), neurological deficit (0.6%), dural tear (0.5%), CSF leakage (0.3%), epidural hematoma (0.9%), and surgical site infection (0.8%). Male sex (OR 3.049; 95% CI 1.045-8.929) and posterior fusion (OR 4.016; 95% CI, 1.518-10.620) were significant risk factors for segmental motor paralysis, while respiratory disease (OR 5.500; 95% CI, 1.462-20.694) was associated with surgical site infection. At 2\u00a0years, patients with complications showed variable neurological recovery, with many failing to reach the minimum clinically important difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Male sex, posterior fusion, and respiratory disease were identified as significant risk factors for major complications. Awareness of these factors may support improved surgical planning and perioperative management. However, interpretation of long-term outcomes should be made with caution because of the limited number of cases and potential selection bias associated with incomplete follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251412810","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T15:33:26Z","timestamp":1766590406000},"page":"2671-2682","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk Factors and Clinical Outcomes of Perioperative Complications Following Cervical Spine Surgery"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-5789","authenticated-orcid":false,"given":"Narihito","family":"Nagoshi","sequence":"first","affiliation":[{"name":"Keio University School of Medicine"},{"name":"Keio Spine Research Group 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