COMPLICATIONS AND MORTALITY AFTER SURGERY FOR DEGENERATIVE CERVICAL MYELOPATHY: OUTCOME ANALYSIS FROM A NEW ZEALAND CENTRE

Introduction Despite increased interest in degenerative cervical myelopathy (DCM), there is a lack of data from New Zealand. This study aims to describe the population of those who have undergone surgery for DCM in Waikato Hospital and analyse their outcomes. Methods All patients that underwent surgery for DCM at Waikato Hospital between the 1st January 2014 and the 1st December 2024 were included. Demographics, co-morbidities, surgical intervention, outcomes, and outpatient follow-ups were recorded. Complications were graded according to the Clavien-Dindo classification. Results 345 surgeries were included. The mean age was 61.8 years. 58.8% were males. 21.5% were Māori. Māori presented for surgery at a younger age than non-Māori individuals (55.6 years and 63.4 years, p < .001). Socioeconomic barriers to health were higher among Māori: higher levels of socioeconomic deprivation (p < .001), higher rates of smoking (standardised residual = 3.28), and poorer follow-up clinic attendance (OR = 4.47, p = .004). 230 (66.7%) had no complications within 30 days of surgery. 51 (14.8%) had a Clavien-Dindo class I, and 18 (5.2%) class IIIb. 7 (2.8%) sustained a C5 nerve palsy. 15 (4.4%) developed surgical site infection (SSI). 6 mortalities within 365 days of surgery were recorded – only one was directly related to the surgery and was within 30 days of surgery. Predictors of infection of SSI include Māori ethnicity (OR = 2.23), current smoking status (OR = 2.62), high deprivation score (OR = 11.99), and worse pre-op function (OR = 5.32). Discussion and Conclusions Selected variables were associated with higher complication risk and may allow for improved pre- operative counselling. The results highlight the need to better understand predisposition to DCM among Māori and ensure equitable healthcare access for timely diagnosis and treatment. Prospective, multicentre data collection is essential to achieve this.