J Korean Neurosurg Soc.  2013 Oct;54(4):323-328. 10.3340/jkns.2013.54.4.323.

The Efficacy and Perioperative Complications Associated with Lumbar Spinal Fusion Surgery, Focusing on Geriatric Patients in the Republic of Korea

• Kim IC
• Hur JW
• Kwon KY
• Lee JJ
• Lee JW
• Lee HK

• KMID: 1499338
• DOI: http://doi.org/10.3340/jkns.2013.54.4.323

Abstract

OBJECTIVE
The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea.
METHODS
We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed.
RESULTS
In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results.
CONCLUSION
Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.

Keyword

Complications; Elderly patients; Lumbar spinal fusion surgery

MeSH Terms

Comorbidity
Follow-Up Studies
General Surgery*
Humans
Judgment
Multivariate Analysis
Republic of Korea*
Retrospective Studies
Risk Factors
Spinal Diseases
Spinal Fusion*

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