J Korean Soc Spine Surg.  2008 Sep;15(3):183-189. 10.4184/jkss.2008.15.3.183.

Perioperative Complications in Elderly Patients Undergoing Lumbar Arthrodesis with Pedicle Screw Instrumentation in the Degenerative Lumbar Disorders: A Comparative Study between Posterolateral Fusion and Posterior Lumbar Interbody Fusion

• Song KJ
• Lim YJ
• Song JH
• Ham DH

• KMID: 1747202
• DOI: http://doi.org/10.4184/jkss.2008.15.3.183

Abstract

STUDY DESIGN: This is a retrospective study that focused on the perioperative complications when performing posterior arthrodesis for treating degenerative lumbar disorders in elderly patients.
OBJECTIVES
We wanted to analyze the perioperative risk factors and the complications associated with posterior lumbar decompression and arthrodesis in patients who were sixty-five years of age or older. SUMMARY OF LITERATURE REVIEW: Lumbar arthrodesis is commonly done in elderly patients to treat degenerative spine problems. These patients may be at an increased risk for complications because of their age and their associated medical conditions.
MATERIALS AND METHODS
We studied 111 patients who were over 65 years old and they were able to be followed up for more than 3 months after performing posterior arthrodesis during the recent 5 years. Sixty-one patients who had undergone posterolateral fusion (PLF) were classified as group A, and 50 patients who had undergone posterior lumbar interbody fusion (PLIF) using a PEEK cage were classified as group B. We analyzed their rates of complications and the causative factors, according to operative methods and age, and these complications occurred within 12 weeks after the operations.
RESULTS
Complications occurred for 43 patients of group A, and for 26 patients of group B. The differences in the rates of complications were statistically significant, and group A had a more complications than did group B. The relations between medical problems and the incidence of perioperative complications were statistically significant for both groups.
CONCLUSIONS
Elderly patients with medical problems should be made aware that they are at an increased risk for surgical complications, and attention hould be paid to controlling the blood loss and limiting the operative time. The PLIF using a PEEK cage was identified as a procedure that could reduce the perioperative complications.

Keyword

Degenerative lumbar disorders; Posterior lumbar interbody fusion; Posterolateral fusion; Perioperative complications

MeSH Terms

Aged
Arthrodesis
Decompression
Humans
Incidence
Ketones
Operative Time
Polyethylene Glycols
Retrospective Studies
Risk Factors
Spine
Ketones
Polyethylene Glycols

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